Sleep Disorders Affect Majority of Elderly (Mayo Rochester)

This press release out of Mayo Rochester (MN) is about a new study in one Minnesota county that showed that “59 percent of 892 people age 70-89 had signs of at least one recognized sleep disorder other than insomnia. The most common disorder, reported by 32 percent of study participants, was sleep-related leg cramps. … Obstructive sleep apnea–characterized by breathing pauses during sleep–occurred in 17.6 percent of participants. … A movement disorder known as REM sleep behavior disorder (RBD) occurred in about 9 percent of participants. This happens when sleepers appear to act out their dreams. … Restless legs syndrome–an irresistible urge to move legs associated with uncomfortable sensations–was suggested in about 8 percent of the study group.”

A Mayo Rochester neurologist who is also a sleep expert, Dr. Brad Boeve, had these comments about the study findings: “Perhaps the biggest surprise of the study is the high frequency of probable RBD in these participants.” The only study on the epidemiology of RBD in the population shows a prevalence of 0.5 percent, whereas these findings suggest a frequency of 9 percent in the 70-89 age range, he says. The frequency matters, he adds, because earlier research by our and other groups has suggested that those with RBD have an increased likelihood of developing a neurologic disorder such as Parkinson’s disease or Lewy body dementia in the future. “One ultimate goal is that once medications are developed that affect the biology of Parkinson’s disease and Lewy body dementia, we hope that they may be used in appropriately-identified individuals with RBD to delay the onset or prevent the development of symptoms associated with those disorders,” Dr. Boeve says.

In our local support group, many people with MSA and LBD have RBD. RBD can be confirmed with a polysomnogram, or a special sleep study that measures eye, leg, and other movements and records breathing and brain activity.

Here are two online video resources about this story:

http://www.youtube.com/watch?v=Kx9aDxv7YyI –> YouTube video of Dr. Jennifer Molano speaking about the study (2.5 minutes)

http://newsblog.mayoclinic.org/2009/04/ … nic-study/ –> scroll down to the Journalists section where you’ll find .wmv and .mp3 files on a study overview, study findings, and patient message

The press release is copied below.

http://www.mayoclinic.org/news2009-rst/5256.html

Sleep Disorders Affect Majority of Elderly Participants in a Large Mayo Clinic Study
Tuesday, April 28, 2009
Mayo Clinic Rochester Press Release

SEATTLE — Sleep disorders are common in the elderly, say researchers from Mayo Clinic who studied a large number of people in this age group in one Minnesota county.

At the 2009 American Academy of Neurology Annual Meeting in Seattle on April 28, the researchers report that 59 percent of 892 people age 70-89 had signs of at least one recognized sleep disorder other than insomnia. The most common disorder, reported by 32 percent of study participants, was sleep-related leg cramps.

The researchers say that their study is one of the first to look at a broader spectrum of sleep disorders in a community’s elderly, and understanding the prevalence of these problems may lead to increased diagnosis followed by beneficial treatment.

“All of these sleep disorders can disrupt a person’s quality of life, because they affect sleep,” says the study’s lead researcher, Jennifer Molano, M.D., a behavioral neurology fellow in the Department of Neurology. “But if these problems are recognized, an accurate diagnosis could lead to successful treatment.”

The research is part of Mayo Clinic’s Study of Aging, a multidisciplinary effort to understand age-related diseases and cognitive functioning. The bed partners of study participants in Olmsted County, Minn., home of Mayo Clinic, answered a questionnaire about how well their partners slept.

The researchers identified these other commonly reported disrupters of sleep:

Obstructive sleep apnea–characterized by breathing pauses during sleep–occurred in 17.6 percent of participants. Men were four times more likely to have features of obstructive sleep apnea compared to women.

Periodic, involuntary movements in the legs or arms during sleep were experienced by 17.4 percent.

A movement disorder known as REM sleep behavior disorder (RBD) occurred in about 9 percent of participants. This happens when sleepers appear to act out their dreams. In this study, men were twice as likely to exhibit recurrent dream enactment behavior as women. The disorder was also seen more often in people age 80 or older who had worsening cognitive impairment or dementia.

Restless legs syndrome–an irresistible urge to move legs associated with uncomfortable sensations–was suggested in about 8 percent of the study group.

Only 0.2 percent of participants were found to walked in their sleep.

“Perhaps the biggest surprise of the study is the high frequency of probable RBD in these participants,” says Bradley Boeve, M.D., a Mayo Clinic neurologist and one of several study investigators.The only study on the epidemiology of RBD in the population shows a prevalence of 0.5 percent, whereas these findings suggest a frequency of 9 percent in the 70-89 age range, he says. The frequency matters, he adds, because earlier research by our and other groups has suggested that those with RBD have an increased likelihood of developing a neurologic disorder such as Parkinson’s disease or Lewy body dementia in the future. “One ultimate goal is that once medications are developed that affect the biology of Parkinson’s disease and Lewy body dementia, we hope that they may be used in appropriately-identified individuals with RBD to delay the onset or prevent the development of symptoms associated with those disorders,” Dr. Boeve says.

The researchers hope to follow up these results with a validation study using a polysomnogram (or sleep study), which measures eye, leg, and other movements and records breathing and brain activity.

The study was funded by grants from the National Institute on Aging, the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program of the Mayo Foundation. Researchers at Mayo Clinic campus in Florida assisted in the study.

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About Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy of “the needs of the patient come first.” More than 3,300 physicians, scientists and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in Rochester, Minn., Jacksonville, Fla., and Scottsdale/Phoenix, Ariz. Collectively, the three locations treat more than half a million people each year. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education visit www.mayo.edu. MayoClinic.com is available as a resource for your health stories.