title: A 5-Year Follow-up Study on the Relationship between Obstructive Sleep Apnea and Parkinson Disease.
abstract: OBJECTIVE
  Sleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset.
  
  
  METHODS
  The data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort.
  
  
  RESULTS
  Of the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA.
  
  
  CONCLUSIONS
  Female patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period.
authors.affiliation: Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan.|Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jau-Jiuan
authors.initials: JJ
authors.lastname: Sheu
authors.affiliation: Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Kao
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.|Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan.|School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
keywords: Parkinson disease; epidemiology; obstructive sleep apnea; parkinsonism; sleep apnea