Sleep disturbance and cognitive disorder: epidemiological analysis in a cohort of 263 patients

Abstract

The aim of this study was to investigate and describe frequency and characteristics of sleep disorders in a large cohort of community dwelling persons with several degrees and typologies of cognitive disorders. 236 patients (78 men and 158 women) were enrolled with different subtypes of dementia: Alzheimer's disease (AD), vascular dementia (VaD), mixed dementia, mild cognitive impairment (MCI), dementia with Lewy bodies (DLB), parkinson's disease dementia (PDD), and frontotemporal lobar degeneration (FTLD), respectively. The sleep disturbances evaluated were: insomnia, excessive daytime sleepiness (EDS), REM behavior disorder (RBD), restless legs syndrome (RLS), and nightmares. Every type of sleep disorder was present in each type of dementia but with significant differences. Insomnia is found to be more present and specific for AD; EDS was associated with the presence of dementia in the elderly with LBD or PDD; RLS and nightmares that were recognized mainly in FTD, LBD, and PDD patients scores; patients with MCI had a frequency of sleep disturbances of any type equal to that of patients with AD presenting mostly insomnia, nightmares or RLS more frequently; nightmares were more frequent among LBD and PDD patients. Frequency of RDB was more frequent in FTD, AD, and VaD. Our findings demonstrate that sleep disturbance was related to dementia. A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of persons with cognitive decline.

The prevalence and clinical risk factors of insomnia in the Chinese elderly based on comprehensive geriatric assessment in Chongqing population

“…30 Every type of sleep disturbance is present in each type of dementia but with significant differences; insomnia is found to be more frequent in Alzheimer's disease. 31 Consistent with previous studies, our results supported the significant correlations between insomnia and mild cognitive impairment and dementia; cognitive impairment had a higher risk of insomnia.…”

Melatonin and Major Neurocognitive Disorders: Beyond the Management of Sleep and Circadian Rhythm Dysfunction

“…The sleep changes observed in dementias (though similar to those reported in normal aging) are more severe than would be expected for the patient's age (Peter-Derex et al, 2015). In patients with dementia due to AD, sleep disturbances tend to occur more frequently than in the general population; it also appears early in the course of the disease Pistacchi et al, 2014;Urrestarazu and Iriarte, 2016), usually becoming more marked with progression of the disease. Studies have observed that these sleep disturbances are associated with increased memory and cognitive impairment (McCurry et al, 2000;Moran eta., 2005).…”

“…There is also evidence that alterations in sleep architecture and sleep disorders may disrupt neuronal pathways that impact brain structure and function (as observed in subjects with obstructive sleep apnoea); presenting a significant risk for the development of neurodegenerative disorders and/or neurocognitive disorders (Ancoli-Israel et al, 1991;Ancoli-Israel et al, 2008;Kim et al, 2011;Kim et al, 2013). Alterations in sleep pattern, which may occur as a consequence of normal aging or neurodegenerative brain disease, has been reported to occur with increasing prevalence in individuals with dementia (Pistacchi et al, 2014;Cipriani et al, 2015). Circadian system alteration, which may manifest as disruption in the daily rhythms of physiologic parameters such as sleep, activity and hormone secretion, have also been observed as a symptom of a number of neurocognitive disorders including Alzheimer disease (Musiek, 2015).…”

The prevalence of insomnia and its risk factors among older adults in a city in Turkey's Aegean Region

“…Insomnia may lead to significant negative outcomes for individuals and society as a whole . Insomnia is associated with decreased quality of life, cognitive impairment, and increases in physical disorders, psychological disorders, and incidence of falls . Elderly with insomnia complain of fatigue, mood changes (e.g.…”