Outpatient treatment of sleep disorders in Alzheimer patients

Scoralick, Francisca Magalhães; Camargos, Einstein Francisco; Freitas, Marco Polo Dias; Nóbrega, Otávio Tolêdo

doi:10.1590/s1679-45082015rw3021

Cited by 9 publications

(5 citation statements)

References 38 publications

(127 reference statements)

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“…Sleep disorders also lower the quality of life for patients and increase stress among caregivers. [8][9][10][11] Although current treatments cannot halt or reverse AD progression, effective treatment can delay its progression and improve the life quality in patients. [12,13] Improving sleep disorders and preventing other BPSD are important in treating AD patients.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of sleep disorders and behavioral and psychological symptoms of dementia in late-onset Alzheimer disease

Zhou

Liu

et al. 2019

Medicine

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Alzheimer disease (AD) is the most common neurodegenerative brain disease that causes cognitive impairment in the elderly. Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors for AD patients. Sleep disorder is one closely-related psychiatric symptom of AD. In this cross-section study, we aimed to investigate the characteristics of sleep status and BPSD among AD patients in Eastern China and to assess the relationship among sleep disorder, BPSD, and cognition.A total of 176 participants were enrolled in the study, including 84 AD patients and 92 healthy individuals as controls. Mini-mental state examination (MMSE), cooperative study-activities of daily living (ADCS-ADL) and clinical dementia rating (CDR) were used to measure cognition, the competence in basic and instrumental activities of daily living, and severity of dementia, respectively. BPSD were evaluated by neuropsychiatric inventory (NPI). Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale were designed to assess the sleep status and daytime naps. Spearman correlation analyses were performed to determine the relations between PSQI, MMSE, ADCS-ADL, and NPI scores and CDR.Sleep disorders occurred in 55.9% of AD patients versus only 15.2% of controls. 89.2% of AD patients had BPSD while only 22.9% of controls did, with apathy (64.

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Section: Introductionmentioning

confidence: 99%

High prevalence of sleep disorders and behavioral and psychological symptoms of dementia in late-onset Alzheimer disease

Zhou

Liu

et al. 2019

Medicine

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“…This also speaks in favor of investigating the roles of melatonin and insulin as the components modulating neuroinflammation in AD pathogenesis. Clinical evidence with benefits obtained in patients experimentally treated for AD by anti-inflammatories [ 68 ], sleep-modifying therapies [ 90 ], or intranasal insulin [ 17 ], corroborates the notion.…”

Section: Shared Pathogenic Mechanisms Of Alzheimer’s Disease and Cmentioning

confidence: 77%

Circadian Rhythm and Alzheimer’s Disease

et al. 2018

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Alzheimer’s disease (AD) is a neurodegenerative disorder with a growing epidemiological importance characterized by significant disease burden. Sleep-related pathological symptomatology often accompanies AD. The etiology and pathogenesis of disrupted circadian rhythm and AD share common factors, which also opens the perspective of viewing them as a mutually dependent process. This article focuses on the bi-directional relationship between these processes, discussing the pathophysiological links and clinical aspects. Common mechanisms linking both processes include neuroinflammation, neurodegeneration, and circadian rhythm desynchronization. Timely recognition of sleep-specific symptoms as components of AD could lead to an earlier and correct diagnosis with an opportunity of offering treatments at an earlier stage. Likewise, proper sleep hygiene and related treatments ought to be one of the priorities in the management of the patient population affected by AD. This narrative review brings a comprehensive approach to clearly demonstrate the underlying complexities linking AD and circadian rhythm disruption. Most clinical data are based on interventions including melatonin, but larger-scale research is still scarce. Following a pathophysiological reasoning backed by evidence gained from AD models, novel anti-inflammatory treatments and those targeting metabolic alterations in AD might prove useful for normalizing a disrupted circadian rhythm. By restoring it, benefits would be conferred for immunological, metabolic, and behavioral function in an affected individual. On the other hand, a balanced circadian rhythm should provide greater resilience to AD pathogenesis.

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“…Sleep disorders, reversal of the daily rhythm, excessive daytime sleepiness and sleeplessness at night are common in AD. 20 Alterations in the suprachiasmatic nucleus and melatonin secretion are the major factors linked with the cause of Circadian Rhythm Disturbances in AD. 21 Circadian Rhythm Disturbances are among the most common reasons for institutionalisation of individuals with AD.…”

Section: Discussionmentioning

confidence: 99%

<p>Use of Methylphenidate in Excessive Daytime Sleepiness in Alzheimer’s Patients Treated with Donepezil: Case Series</p>

Bidzan

2020

NDT

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Sleep disorders, inversion of sleep rhythm, excessive daytime sleepiness, and sleeplessness at night are common in Alzheimer's disease (AD). Sleep disorders in AD have a diverse pathogenesis and their incidence increases as the disease progresses. Some publications indicate possible beneficial effects of methylphenidate on sleep. We presented two cases of patients with diagnosed AD accompanied by sleep disorders which had a significant impact on their functioning. The pathogenesis of sleep disorders was different in those two cases. In both case studies, the use of methylphenidate brought an immediate clinical effect, improving sleep at night and functioning during the day.

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Outpatient treatment of sleep disorders in Alzheimer patients

Cited by 9 publications

References 38 publications

High prevalence of sleep disorders and behavioral and psychological symptoms of dementia in late-onset Alzheimer disease

High prevalence of sleep disorders and behavioral and psychological symptoms of dementia in late-onset Alzheimer disease

Circadian Rhythm and Alzheimer’s Disease

<p>Use of Methylphenidate in Excessive Daytime Sleepiness in Alzheimer’s Patients Treated with Donepezil: Case Series</p>

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