INTRODUCTION Limited evidence indicates an association between sleep factors and the risk of Parkinson's disease (PD). However, large prospective cohort studies including both sexes are needed to verify the association between daytime sleepiness, sleep duration, and PD risk. Furthermore, other sleep factors like chronotype and snoring and their impact on increased PD risk should be explored by simultaneously considering daytime sleepiness and snoring. METHODS This study included 409,923 participants from the UK Biobank. Data on five sleep factors (chronotype, sleep duration, sleeplessness/insomnia, snoring, and daytime sleepiness) were collected using a standard self-administered questionnaire. PD occurrence was identified using linkages with primary care, hospital admission, death register, or self-report. Cox proportional hazard models were used to investigate the association between sleep factors and PD risk. Subgroup (age and sex) and sensitivity analyses were performed. RESULTS During a median follow-up of 11.89 years, 2,158 incident PD cases were documented. The main association analysis showed that prolonged sleep duration (hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.05, 1.37) and occasional daytime sleepiness (HR: 1.15, 95% CI: 1.04, 1.26) increased the PD risk. Compared to those who self-reported never or rarely having sleeplessness/insomnia, participants who reported usually having sleeplessness/insomnia had a decreased risk of PD (HR: 0.85, 95% CI: 0.75, 0.96). Subgroup analysis revealed that women who self-reported no snoring had a decreased PD risk (HR: 0.85; 95% CI: 0.73, 0.99). Sensitivity analyses indicated that the robustness of the results was affected by potential reverse causation and data completeness. CONCLUSION Long sleep duration increased the PD risk, especially among men and participants ≥60 years, while snoring increased the risk of PD in women. Additional studies are needed to (i) further consider other sleep traits (e.g., rapid eye movement sleep behavior disorder and sleep apnea) that might be related to PD, (ii) objectively measure sleep-related exposure, and (iii) confirm the effects of snoring on PD risk by considering the impact of obstructive sleep apnea and investigating its underlying mechanisms.

中文翻译：

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睡眠因素与帕金森病之间的关联：基于 409,923 名英国生物银行参与者的前瞻性研究。

简介 有限的证据表明睡眠因素与帕金森病 (PD) 风险之间存在关联。然而，需要包括男女在内的大型前瞻性队列研究来验证日间嗜睡、睡眠持续时间和帕金森病风险之间的关联。此外，应同时考虑白天嗜睡和打鼾，探讨其他睡眠因素，如睡眠时间型和打鼾及其对 PD 风险增加的影响。方法 这项研究包括来自英国生物银行的 409,923 名参与者。使用标准自填问卷收集五种睡眠因素（睡眠时间型、睡眠持续时间、失眠/失眠、打鼾和白天嗜睡）的数据。PD 的发生是通过与初级保健、入院、死亡登记或自我报告的联系来确定的。Cox 比例风险模型用于研究睡眠因素与 PD 风险之间的关联。进行了亚组（年龄和性别）和敏感性分析。结果 在 11.89 年的中位随访期间，记录了 2,158 例 PD 病例。主要关联分析显示，延长睡眠时间（风险比 [HR]：1.20，95% 置信区间 [CI]：1.05，1.37）和偶尔的白天嗜睡（HR：1.15，95% CI：1.04，1.26）会增加 PD风险。与那些自我报告从未或很少患有失眠/失眠的参与者相比，经常患有失眠/失眠的参与者患 PD 的风险较低（HR：0.85，95% CI：0.75，0.96）。亚组分析显示，自我报告不打鼾的女性 PD 风险较低（HR：0.85；95% CI：0.73，0.99）。敏感性分析表明，结果的稳健性受到潜在反向因果关系和数据完整性的影响。结论 睡眠时间长会增加 PD 风险，尤其是男性和 60 岁以上的参与者，而打鼾会增加女性 PD 风险。需要进行更多研究以 (i) 进一步考虑可能与 PD 相关的其他睡眠特征（例如快速眼动睡眠行为障碍和睡眠呼吸暂停），(ii) 客观测量与睡眠相关的暴露，以及 (iii) 确认影响通过考虑阻塞性睡眠呼吸暂停的影响并调查其潜在机制，研究打鼾对帕金森病风险的影响。