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From the Division of Biostatistics and Epidemiology (Dr. Abbott), University of Virginia School of Medicine, Charlottesville, VA; the Pacific Health Research Institute (Drs. Abbott, Ross, White, Masaki, Nelson, Curb, and Petrovich), the Department of Veterans' Affairs (Drs. Ross, White, and Petrovich), the Honolulu-Asia Aging Study, Kuakini Medical Center (Drs. Abbott, Ross, White, Masaki, Curb, and Petrovich), the Department of Geriatric Medicine (Drs. Abbott, Ross, Masaki, Curb, and Petrovich), the Department of Medicine (Drs. Ross, Curb, and Petrovich), and the Department of Pathology (Dr. Nelson), John A. Burns School of Medicine, University of Hawaii, Honolulu, HI; and the Parkinson's Institute (Dr. Tanner), Sunnyvale, CA.
Address correspondence and reprint requests to Dr. Robert D. Abbott, University of Virginia Health System, Department of Public Health Sciences, P.O. Box 800717, Charlottesville, VA 22908-0717; e-mail: rda3e{at}virginia.edu
Objective: To determine if excessive daytime sleepiness (EDS) can predate future Parkinson disease (PD).
Methods: EDS was assessed in 3,078 men aged 71 to 93 years in the Honolulu-Asia Aging Study from 1991 to 1993. All were free of prevalent PD and dementia. Follow-up for incident PD was based on three repeat neurologic assessments from 1994 to 2001.
Results: During the course of follow-up, 43 men developed PD (19.9/10,000 person-years). After age adjustment, there was more than a threefold excess in the risk of PD in men with EDS vs men without EDS (55.3 vs 17.0/10,000 person-years; odds ratio [OR] = 3.3; 95% CI = 1.4 to 7.0; p = 0.004). Additional adjustment for insomnia, cognitive function, depressed mood, midlife cigarette smoking and coffee drinking, and other factors failed to alter the association between EDS and PD (OR = 2.8; 95% CI = 1.1 to 6.4; p = 0.014). Other sleep related features such as insomnia, daytime napping, early morning grogginess, and frequent nocturnal awakening showed little relation with the risk of PD.
Conclusions: Excessive daytime sleepiness may be associated with an increased risk of developing Parkinson disease.
Supported by the National Institute on Aging (contract N01-AG-4-2149 and grant 1-R01-AG17155-01A1), the National Heart, Lung, and Blood Institute (contract N01-HC-05102), the National Institute of Neurological Disorders and Stroke (grant 1-R01-NS41265-01), the United States Department of the Army (grant DAMD17-98-1-8621), and by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs.
Disclosure: The authors report no conflicts of interest.
Received May 11, 2005. Accepted in final form July 22, 2005.
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