title: Excessive daytime sleepiness and subsequent development of Parkinson disease.
abstract: 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.
authors.affiliation: Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VA, USA. rda3e@virginia.edu
authors.forename: R D
authors.initials: RD
authors.lastname: Abbott
authors.forename: G W
authors.initials: GW
authors.lastname: Ross
authors.forename: L R
authors.initials: LR
authors.lastname: White
authors.forename: C M
authors.initials: CM
authors.lastname: Tanner
authors.forename: K H
authors.initials: KH
authors.lastname: Masaki
authors.forename: J S
authors.initials: JS
authors.lastname: Nelson
authors.forename: J D
authors.initials: JD
authors.lastname: Curb
authors.forename: H
authors.initials: H
authors.lastname: Petrovitch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002110:Caffeine / Q000009:adverse effects; D015984:Causality; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects
chemical_list: D002110:Caffeine