Clinical correlates of sleep profiles in dementia with Lewy bodies: a latent class approach
Abstract
Background: Rapid eye movement behavioral disorder (RBD) is a well-studied feature of dementia with Lewy bodies (DLB). However, patients with DLB report a significantly wider range of sleep symptoms than those of RBD. Our objective was to characterize profiles of sleep disturbances in DLB.
Methods: Retrospective cross-sectional study including patients with DLB fulfilling McKeith et al. diagnostic criteria in 3 centers at AP-HP GHU Nord, Paris, France. Nine sleep symptoms were evaluated. Latent class analysis was performed on sleep symptoms to identify underlying patterns. Classes were compared on demographic and clinical characteristics.
Results: Among 359 patients (age 74.6 ± 7.5 years; 49% female, disease evolution: 4.6 ± 4.1 years), 95% had sleep disturbances. The most frequent symptoms included excessive daytime sleepiness (70.8%), probable RBD (67.7%), and insomnia/sleep fragmentation (60.9%). A motor disease onset was associated with RBD and nightmares, and a psychiatric onset with insomnia/sleep fragmentation. Latent class analysis identified three sleep profiles: a "Global sleep impairment" profile (n = 106) with the highest sleep-symptom burden, advanced cognitive impairment, and frequent hallucinations and fluctuations; a "RBD - Nightmares" profile (n = 149) associated with dysautonomia, clinical breathing disturbances and better-preserved cognition; and a "Paucisymptomatic" profile (n = 104) with the lowest sleep-symptom burden but advanced cognitive impairment.…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 359 participants or records.
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