Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review

Guarnieri, Biancamaria; Musicco, Massimo; Caffarra, Paolo; Adorni, Fulvio; Appollonio, Ildebrando; Arnaldi, Dario; Bartoli, Antonella; Bonanni, Enrica; Bonuccelli, Ubaldo; Caltagirone, Carlo; Cerroni, Gianluigi; Concari, Letizia; Cosentino, F.; Fermi, Silvia; Ferri, Raffaele; Gelosa, Giorgio; Lombardi, Gemma; Mearelli, S.; Nobili, Flavio; Passero, S.; Perri, Roberta; Rocchi, Raffaele; Sucapane, Patrizia; Tognoni, Gloria; Zabberoni, Silvia; Sorbi, Sandro

doi:10.1007/s10072-014-1873-7

Cited by 25 publications

(15 citation statements)

References 163 publications

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“…Recommendations from the Sleep Study Group of the Italian Dementia Research Association regarding management of sleep-disordered breathing in dementia or mild cognitive impairment include referral to a sleep specialist or sleep centre. They also enlist strong evidence for help from carer or family member as being generally necessary as well as suggesting that offering CPAP to patients with cognitive decline who can comply is reasonable (Guarnieri et al, 2014).…”

Section: Interventionsmentioning

confidence: 99%

Obstructive sleep apnoea and dementia: is there a link?

Shastri

Bangar

Holmes

2015

Int J Geriatr Psychiatry

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While there are numerous studies that establish a clear relationship between obstructive sleep apnoea, cognitive decline and dementia, more work is needed in understanding the mechanism and processes involved. A detailed understanding of pathophysiology of sleep and the relationship with cognitive decline will be vital in addressing the possibility of averting a likely reversible cause of dementia or cognitive decline.

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Section: Interventionsmentioning

confidence: 99%

Obstructive sleep apnoea and dementia: is there a link?

Shastri

Bangar

Holmes

2015

Int J Geriatr Psychiatry

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“…An affirmative response to the question was 98% sensitive and 74% specific for PSG-confirmed RBD; the specificity increased depending on the responses to additional questions if there was no history suggesting OSA [56] . The core question used in the Italian multicenter study to assess clinically probable RBD is similar to the Mayo Questionnaire and can also be used [54] .…”

Section: Recommendations On Clinical Assessment and Management Of Slementioning

confidence: 99%

“…The SINDem group recently prepared specific recommendations for sleep disorders in individuals with MCI and dementia, which were approved by the Italian Neurological Association on February 14, 2014 [54] . The recommendations are directed at professionals (primarily but not exclusively neurologists) involved in the complex diagnostic work-up of dementia patients; their aim is to establish uniform levels of care, to promote collaborative research into areas of uncertainty and to define the qualitative characteristics that distinguish dementia and sleep centers.…”

Section: Recommendations On Clinical Assessment and Management Of Slementioning

confidence: 99%

Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia

Guarnieri¹,

Sorbi

2015

Eur Neurol

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Background: Sleep disturbances and disruption of the neural regulation of the sleep-wake rhythm appear to be involved in the cellular and molecular mechanisms of cognitive decline. Although sleep problems are highly prevalent in mild cognitive impairment (MCI) and many types of dementia, they have not been systematically investigated in the clinical setting and are often only investigated by sleep specialists upon individual request. Summary: This review discusses sleep disorders in the context of cognitive decline and provides an overview of the clinical diagnosis and management of these disorders in patients with dementia and MCI. Key Messages: Sleep disorders are largely underestimated and do not receive sufficient attention in the global management of dementia patients. Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression. They are positively associated with the severity of behavioral problems and cognitive impairment. Clinical Implications: The recent recommendations by the Sleep Study Group of the Italian Dementia Research Association can be used as a guideline for the clinical assessment and management of sleep disorders in MCI and dementia patients. Sleep disorders should be carefully investigated using an in-depth sleep history, physical examination, questionnaires and clinical scales and should be validated with the support of a direct caregiver. The recommendations for older adults can be used as a framework to guide the diagnosis and treatment of sleep disorders in individuals with dementia and MCI. The management strategy should be based on the choice of different treatments for each sleep problem present in the same patient, while avoiding adverse interactions between treatments.

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“…Enhanced microglial activation has been shown to be related to postischemic inflammation and has been implicated in the pathogenesis of cerebral I/R injury (59). Suppression of microglial activation prevents brain damage following cerebral I/R injury (20,53,63). In addition, antioxidants can attenuate microglial activa-…”

Section: Discussionmentioning

confidence: 99%

Mito-Tempo prevents nicotine-induced exacerbation of ischemic brain damage

Sun

et al. 2018

Journal of Applied Physiology

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Nicotine may contribute to the pathogenesis of cerebrovascular disease via the generation of reactive oxygen species (ROS). Overproduction of ROS leads to brain damage by intensifying postischemic inflammation. Our goal was to determine the effect of Mito-Tempo, a mitochondria-targeted antioxidant, on ischemic brain damage and postischemic inflammation during chronic exposure to nicotine. Male Sprague-Dawley rats were divided into four groups: control, nicotine, Mito-Tempo-treated control, and Mito-Tempo-treated nicotine. Nicotine (2 mg·kg·day) was administered via an osmotic minipump for 4 wk. Mito-Tempo (0.7 mg·kg·day ip) was given for 7 days before cerebral ischemia. Transient focal cerebral ischemia was induced by occlusion of the middle cerebral artery for 2 h. Brain damage and inflammation were evaluated after 24 h of reperfusion by measuring infarct volume, expression of adhesion molecules, activity of matrix metalloproteinase, brain edema, microglial activation, and neutrophil infiltration. Nicotine exacerbated infarct volume and worsened neurological deficits. Nicotine did not alter baseline ICAM-1 expression, matrix metallopeptidase-2 activity, microglia activation, or neutrophil infiltration but increased these parameters after cerebral ischemia. Mito-Tempo did not have an effect in control rats but prevented the chronic nicotine-induced augmentation of ischemic brain damage and postischemic inflammation. We suggest that nicotine increases brain damage following cerebral ischemia via an increase in mitochondrial oxidative stress, which, in turn, contributes to postischemic inflammation. NEW & NOTEWORTHY Our findings have important implications for the understanding of mechanisms contributing to increased susceptibility of the brain to damage in smokers and users of nicotine-containing tobacco products.

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Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review

Cited by 25 publications

References 163 publications

Obstructive sleep apnoea and dementia: is there a link?

Obstructive sleep apnoea and dementia: is there a link?

Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia

Mito-Tempo prevents nicotine-induced exacerbation of ischemic brain damage

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