0954 Association between Sleep Disturbance in Alzheimer's Disease Patients and Burden on and Health Status of Their Caregivers

Okuda, Shoki; Tetsuka, Jumpei; Takahashi, Ken­ichi; Toda, Yasuo; Kubo, Takekazu; Tokita, Shigeru

doi:10.1093/sleep/zsz067.952

Cited by 3 publications

(3 citation statements)

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“…In our study, there was no association of caregiver burden with total score of the PSQI, although there was a positive correlation of caregiver burden with the score of sleep latency, one of seven components of PSQI (r = 0.396, p < 0.05) (Table 3). Okuda et al [33] have reported that self-reported poor sleep quality of AD patients assessed by the Sleep Disorders Inventory (SDI) is associated with increased caregiver burden. The SDI is a questionnaire that evaluates the severity and frequency of sleep-related problems derived from the NPI (insomnia, night roaming, daytime sleep, etc.).…”

Section: Discussionmentioning

confidence: 99%

Relationship of Subjective and Objective Sleep Quality with Caregiver Burden in Patients with Alzheimer’s Disease

Lee

Kim²,

Lee³

et al. 2021

Sleep Med Res

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Background and ObjectiveaaSleep disturbance in patients with Alzheimer's disease (AD) could increase institutionalization due to caregiver burden. The objective of this study was to examine the relationship of subjective and objective sleep quality with caregiver burden in AD patients with insomnia symptoms. MethodsaaAD patients of mild to moderate degree were recruited. They were assessed with the Pittsburgh Sleep Quality Index (PSQI), Korean version of the Epworth Sleepiness Scale, and Mini-Mental Status Examination in the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. Caregiver burden was evaluated with Korean version of the Neuropsychiatric Inventory Questionnaire (KNPI-Q) and Korean version of the Zarit Burden Interview (ZBI-K). Actigraphy recording (Actiwatch 2; Philips Respironics) was conducted for five days at home. Thirty-four patients (age 78.44 ± 6.14, M:F = 9:25) were analyzed. These patients were divided into two groups by the median of KNPI-Q for caregiver distress [KNPI-Q(d)] and ZBI-K scores. Sleep parameters were compared between the two groups. ResultsaaAmong seven components of PSQI, sleep latency was correlated with KNPI-Q(d) score. The patients with higher KNPI-Q(d) scores had lower sleep efficiency (SE) (p = 0.002), greater wake after sleep onset (p = 0.037), and higher fragmentation index (p = 0.040) than those with lower KNPI-Q(d) scores. Those with higher ZBI-K scores had lower SE (p = 0.026) than those with lower ZBI-K scores. Stepwise multiple regression revealed that SE predicted 16% of KNPI-Q(d) scores (p = 0.012). ConclusionsaaDifficulty in sleep initiation according to subjective reports was associated with caregiver burden in our AD patients. In objective sleep quality, a significant difference in difficulty of sleep maintenance was found between higher and lower caregiver burden groups. This suggests that sleep maintenance is essential for reducing caregiver burden.

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Section: Discussionmentioning

confidence: 99%

Relationship of Subjective and Objective Sleep Quality with Caregiver Burden in Patients with Alzheimer’s Disease

Lee

Kim²,

Lee³

et al. 2021

Sleep Med Res

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“…We were unable to use the anchoring method as our anchor, quality of life, was not associated with overall sleep disturbances. As the SDI is currently the only validated dementia specific sleep disturbance questionnaire, and is being used in recently published studies measuring sleep in people with dementia including a randomised controlled trial, 30,38‐41 these results will also be helpful for researchers to use in future studies.…”

Section: Discussionmentioning

confidence: 99%

The minimum clinically important difference on the sleep disorders inventory for people with dementia

Webster¹,

Martin²,

Livingston³

2020

Int J Geriat Psychiatry

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Objectives: Sleep disturbances in dementia causes distress to people with dementia and their family carers and are associated with care home admission. The Sleep Disorders Inventory (SDI) is a validated questionnaire of sleep disturbances in dementia often used to measure treatment effectiveness, but the minimum clinically important difference (MCID) is unknown. Methods: We triangulated three investigative methods to determine the MCID of the SDI. Using data on SDI from a randomised controlled trial (RCT) with 62 participants in an intervention for sleep disorders in dementia, we (1) calculated distribution-based values where MCID = 0.33 of a SD (SD) (2) an anchor based approach using quality of life (measured using DEMQOL-Proxy) as an anchor. We also employed a Delphi consensus process asking 12 clinicians, sleep researchers and family carers to rate which changes on vignettes were equivalent to a MCID. Results: We found that 0.33 SD in the SDI = 4.86. Reduction in SDI total score was not significantly correlated with improvement in DEMQOL-Proxy (Pearson's correlation = −0.01; P = 0.96) score. The Delphi consensus required two rounds to reach a consensus and concluded that changes equivalent to three points on the SDI equated to the MCID. Conclusions: Taking into account both the distribution-based values and the Delphi process we used a whole number at the midpoint and judged the minimum clinically

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“…Sleep disturbance in typical AD is thought to involve exaggeration of age‐related increase in nocturnal awakenings, along with a prominent decrease in slow‐wave sleep (SWS), but a modest decline in total sleep and REM sleep time, and an increased propensity for daytime sleep 3 . Worsening sleep disruption along with the disease course is associated with greater cognitive decline, negatively impacts quality of life, increases caregiver burden, and causes early institutionalization 4 . Although confluent evidence supports that sleep disturbances manifest early in the disease course, even preceding cognitive decline, misdiagnosis and undertreatment are frequent 3,5 .…”

Section: Open‐peer Commentarymentioning

confidence: 99%

Deepen into sleep and wake patterns across Alzheimer's disease phenotypes

Falgàs

Walsh

Neylan

et al. 2021

Alzheimer's & Dementia

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Although, the clinical variants of Alzheimer's disease (AD) show distinct patterns of cognitive and behavioral decline, disease progression, and neuropathological features, it is unclear if this clinical heterogeneity extends to sleep‐wake patterns. Sleep and wake disturbances are frequent in typical AD, often preceding memory loss and negatively impacting the quality of life of patients and caregivers alike. Still, sleep and wake disorders are often misdiagnosed and undertreated in typical AD. Better characterization of sleep‐wake features in AD clinical variants is an unmet gap of high importance because these differing patterns may require tailored treatment strategies. Moreover, as wake‐promoting neurons are located in subcortical nuclei and degenerate early in typical AD, contrasting the profiles of sleep‐wake patterns in typical and atypical AD aids diagnosis and brings a unique opportunity to uncover the mechanisms underlying AD clinical variants at the subcortical level and mechanisms for selective neuronal vulnerability.

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0954 Association between Sleep Disturbance in Alzheimer's Disease Patients and Burden on and Health Status of Their Caregivers

Cited by 3 publications

References 0 publications

Relationship of Subjective and Objective Sleep Quality with Caregiver Burden in Patients with Alzheimer’s Disease

Relationship of Subjective and Objective Sleep Quality with Caregiver Burden in Patients with Alzheimer’s Disease

The minimum clinically important difference on the sleep disorders inventory for people with dementia

Deepen into sleep and wake patterns across Alzheimer's disease phenotypes

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