epidemiologic study ; neurodegenerative disease ; predictive model ; risk factor ; sleep behavior ; sleep disorder
Abstract
INTRODUCTION The impact of sleep disorders (SDs) on incident neurodegenerative disease (NDD) risk has not been comprehensively investigated.METHODS In the UK Biobank cohort, 30,032 participants with SDs (defined by diagnostic codes) and 147,321 without SDs were included. Cox proportional hazards models assessed associations between SDs and NDD risk. NDD prediction models incorporating SD subtype variables were developed.RESULTS SD was associated with increased NDD risk (hazard ratio [HR]: 1.32, 95% confidence interval: 1.23 to 1.41). This association was observed regardless of treatment status, and several SD subtypes were also associated with increased NDD risk. Sleep behaviors, including difficulty waking and usual daytime napping, were associated with higher NDD risk among individuals with SD. SD subtype variables improved NDD prediction model performance and clinical utility in an external cohort.DISCUSSION SDs and related sleep behaviors were strong predictors of NDD risk, underscoring their potential as targets for early prevention strategies.