Journal ArticleDOI
Sleep Dysfunction in Alzheimer's Disease and Other Dementias.
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TLDR
Dementia patients should be evaluated for common primary sleep disorders that may contribute to nighttime behavioral disturbances and impact treatment decisions.Abstract:
Changes in sleep architecture and circadian rhythms, including increased sleep latency and nighttime awakenings, decreased slow-wave sleep, rapid eye movement sleep, and total sleep time, and increased daytime napping are widespread in people with dementia. In addition, cyclic agitation episodes (“sundowning”), nightmares or hallucinations, sleep attacks, and nocturnal behavioral outbursts are associated with specific dementia syndromes. Sleep hygiene recommendations, particularly those aimed at reducing daytime sleep and improving the sleep environment and routine, can offset the circadian disturbances of some dementia patients. However, they can be burdensome for caregivers to implement, and must be targeted to the specific patterns of sleep disturbances patients are experiencing. Pharmacologic treatments may be useful for symptomatic treatment of insomnia and nighttime behavioral disturbances in dementia patients, but there have been few controlled trials demonstrating their efficacy or long-term safety. Clonazepam is highly effective for treating the nighttime behaviors associated with rapid eye movement behavior disorder. For most dementia patients, however, the side effect risks of prolonged use of sedating medications must be weighed against the potential benefits. Dementia patients should be evaluated for common primary sleep disorders that may contribute to nighttime behavioral disturbances and impact treatment decisions. Continuous positive airway pressure, the gold standard for treating obstructive sleep apnea, can be tolerated by mild to moderately demented individuals with support from supervising caregivers. Increased daily light exposure and physical activity may help normalize circadian restactivity rhythms in some dementia patients, although the frequency and dose needed to maintain treatment effects is currently not known.read more
Citations
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Journal ArticleDOI
Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey.
TL;DR: The results suggest that the sleep complaints common in older adults are often secondary to their comorbidities and not to aging per se, consistent with epidemiological studies of sleep, aging and chronic disease.
Journal ArticleDOI
Nighttime insomnia treatment and education for Alzheimer's disease: a randomized, controlled trial.
TL;DR: In this article, the authors evaluated whether a comprehensive sleep education program (Nighttime Insomnia Treatment and Education for Alzheimer's Disease (NITE-AD)) could improve sleep in dementia patients living at home with their family caregivers.
Journal ArticleDOI
Melatonin and bright-light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease.
Glenna A. Dowling,Robert L. Burr,Eus J.W. Van Someren,Erin Hubbard,Jay S. Luxenberg,Judy Mastick,Bruce A. Cooper +6 more
TL;DR: To test whether the addition of melatonin to bright‐light therapy enhances the efficacy in treating rest–activity (circadian) disruption in institutionalized patients with Alzheimer's disease (AD).
Journal ArticleDOI
Concurrent Impairments in Sleep and Memory in Amnestic Mild Cognitive Impairment
Carmen E. Westerberg,Bryce A. Mander,Susan M. Florczak,Sandra Weintraub,M.-Marsel Mesulam,Phyllis C. Zee,Ken A. Paller +6 more
TL;DR: It is suggested that sleep changes in aMCI patients contribute to memory impairments by interfering with sleep-dependent memory consolidation.
Journal ArticleDOI
Aging and Circadian Rhythms.
TL;DR: Key features of the human circadian timing system, age-related changes in the circadian timingSystem, and how those changes may contribute to the observed alterations in sleep are reviewed.
References
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Journal ArticleDOI
Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases.
TL;DR: It is concluded that RBD is a well-defined condition and that descriptions from different centres are fairly consistent, and that attention to the safety of the bed environment may be sufficient for patients with contraindications to the drug.
Journal ArticleDOI
Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy.
TL;DR: Whether rapid eye movement (REM) sleep behavior disorder occurs in disproportionally greater frequency in multiple system atrophy, Parkinson's disease, and dementia with Lewy bodies, collectively known as the synucleinopathies, compared to other nonsynucleinopathy neurodegenerative disorders is examined.
Journal ArticleDOI
Bright Light Therapy: Improved Sensitivity to Its Effects on Rest-Activity Rhythms in Alzheimer Patients by Application of Nonparametric Methods
E.J.W. van Someren,Dick F. Swaab,Christopher C. Colenda,Wayne Cohen,McCall Wv,Peter B. Rosenquist +5 more
TL;DR: In this article, the effect of bright light on actigraphically assessed rest-activity rhythms in demented elderly were reanalyzed using several statistical procedures, and it was demonstrated that the light-induced improvement in coupling of the rest activity rhythm to the environmental zeitgeber of the bright light is better detected using nonparametric procedures.
Journal ArticleDOI
Periodic limb movements in sleep in community-dwelling elderly.
Sonia Ancoli-Israel,Daniel F. Kripke,Daniel F. Kripke,Melville R. Klauber,William J. Mason,William J. Mason,Robert Fell,Robert Fell,Kaplan O +8 more
TL;DR: No combination of demographic variables and symptoms allowed highly reliable prediction of PLMS, and the strengths of the associations between interview variables and myoclonus indices were all small.
Journal ArticleDOI
Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients
TL;DR: During increased illumination, the stability of the rest-activity rhythm increased in patients with intact vision, but not in visually impaired patients, and the hypothesis than an enduring increase in the daytime environmental illumination level improves rest- activity rhythm disturbances in demented patients is tested.