Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer’s Disease, and Normal Aging

Cagnin, Annachiara; Fragiacomo, Federica; Camporese, Giulia; Turco, Matteo; Bussè, Cinzia; Ermani, Mario; Montagnese, Sara

doi:10.3233/jad-160385

Cited by 45 publications

(33 citation statements)

References 35 publications

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“…According to previous reports, no subjective sleep measures were related to cognitive performance, irrespective of their differences in time frame . This could be explained by the limited appropriateness of self‐reports in this patient population, potentially due to poor symptom awareness or cognitive deficits contributing to a disagreement between subjective and actigraphic sleep measures …”

Section: Discussionmentioning

confidence: 96%

“…3,30 This could be explained by the limited appropriateness of self-reports in this patient population, 32 potentially due to poor symptom awareness or cognitive deficits contributing to a disagreement between subjective and actigraphic sleep measures. 10,33 With regard to pathophysiological considerations, there is evidence for an association-probably a bidirectional association-between disturbed sleep and both amyloid deposition and tau pathology. 34 Unfortunately, only the minority of our patients underwent lumbar puncture to measure cerebrospinal fluid biomarkers.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, one study on non‐amnestic MCI patients revealed an association between disrupted sleep continuity as assessed by actigraphy and poorer performance on specific neuropsychological domains . In contrast, group comparisons of subjective sleep parameters yielded inconsistent results with negative or even contrary findings, indicating poorer sleep quality in healthy elderly subjects than in cognitively impaired subjects …”

Section: Introductionmentioning

confidence: 99%

“…9 In contrast, group comparisons of subjective sleep parameters yielded inconsistent results with negative or even contrary findings, 3 indicating poorer sleep quality in healthy elderly subjects than in cognitively impaired subjects. 10 Apart from cross-sectional results, several longitudinal studies have addressed the role of sleep in cognitive decline. According to these studies, future risk of cognitive deterioration or conversion from MCI to dementia was predictable by different measures of sleep disturbances as assessed by self-rating scales, 11 actigraphy, 12 and polysomnography.…”

Section: Introductionmentioning

confidence: 99%

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Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients

et al. 2019

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Aim Sleep disturbances are prevalent in various dementia subtypes but rarely investigated in early clinical stages. Although memory clinics have become an established institution for the early diagnosis of dementia, sleep assessment is not part of their routine diagnostics. This study aimed to examine whether subjective and objective sleep variables are related to cognitive impairment in patients referred to a memory clinic. Methods On two consecutive days, patients underwent routine diagnostic procedures, including a neuropsychological examination (consortium to establish a registry for alzheimer's disease), and had their sleep quality evaluated by the Pittsburgh Sleep Quality Index and overnight hand‐wrist actigraphy. Results Data of 31 patients (age, M ± SEM: 74.1 ± 1.5; 18 women, 13 men; Clinical Dementia Rating: 0–1) were analysed. One had been diagnosed with subjective cognitive impairment, 13 with mild cognitive impairment with or without depression, and 17 with dementia syndrome due to Alzheimer's and/or cerebrovascular disease. Compared to patients with subjective or mild cognitive impairment, dementia patients showed a significantly increased nocturnal acceleration magnitude; other differences in subjective and objective sleep measures were not significant. Comparing patients with subjectively poor (Pittsburgh Sleep Quality Index > 5: n = 9) and good sleep (Pittsburgh Sleep Quality Index ≤ 5: n = 22) yielded no differences in any neuropsychological and clinical variables. In contrast, patients with low actigraphically recorded sleep efficiency (<85%: n = 11) exhibited a significantly more impaired cognitive performance than those in the high sleep efficiency group (≥85%: n = 20). Correlation analyses demonstrated that actigraphically assessed disturbed sleep continuity accompanied by increased night‐time motor activity was substantially associated with cognitive impairment. Conclusion This study highlights that objectively assessed, but not self‐reported, parameters of disturbed sleep are closely related to cognitive dysfunction in the early stages of dementia of different aetiologies. Possible diagnostic and treatment implications are discussed.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients

et al. 2019

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“…The inverse, a pattern of hypersomnolence dominance is observed in early stages of synucleinopathies, especially dementia with Lewy bodies, and is accompanied by a leftward shift in spectral power. Interestingly, later stages in synucleinopathies often tend to resemble a twilight zone pattern, possibly reflective of evolving synuclein and AD co-pathology or advanced disease severity [76,129,130]. The model also takes a broader approach compared to other models, including elements beyond sleep, such as wakefulness and ultradian patterns (Fig.…”

Section: Novelty and Comparison To Other Modelsmentioning

confidence: 99%

Brain rhythm attractor breakdown in Alzheimer's disease: Functional and pathologic implications

Karageorgiou

Vossel

2017

Alzheimer's & Dementia

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This perspective binds emerging evidence on the bidirectional relationship between Alzheimer’s disease (AD) and sleep disorders through a model of brain rhythm attractor breakdown. This approach explains behavioral-cognitive changes in AD across the sleep-wake cycle and supports a causal association between early brainstem tau pathology and subsequent cortical amyloid-β accumulation. Specifically, early tau dysregulation within brainstem-hypothalamic nuclei leads to breakdown of sleep-wake attractor networks, with patients displaying an attenuated range of behavioral and electrophysiological activity patterns, a “twilight zone” of constant activity between deep rest and full alertness. This constant cortical activity promotes activity-dependent amyloid-β accumulation in brain areas that modulate their activity across sleep-wake states, especially the medial prefrontal cortex (mPFC). Additionally, the accompanying breakdown of hippocampal-mPFC interplay across sleep stages could explain deficient memory consolidation through dysregulation of synaptic plasticity. Clinical implications include the potential therapeutic benefit of attractor consolidation (e.g., slow-wave sleep enhancers) in delaying AD progression.

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Sleep disturbances in Lewy body dementia: A systematic review

Elder

Lázár

Alfonso‐Miller

et al. 2022

Int J Geriat Psychiatry

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Background: Lewy body dementia (LBD) refers to both dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). Sleep disturbances are common in LBD, and can include poor sleep quality, excessive daytime sleepiness (EDS), and rapid eye movement behaviour disorder (RBD). Despite the high clinical prevalence of sleep disturbances in LBD, they are under-studied relative to other dementias. The aim of the present systematic review was to examine the nature of sleep disturbances in LBD, summarise the effect of treatment studies upon sleep, and highlight specific and necessary directions for future research. Methods: Published studies in English were located by searching PubMED and PSYCArticles databases (until 10 June 2022). The search protocol was preregistered in PROSPERO (CRD42021293490) and performed in accordance with PRISMA guidelines. Results: Following full-text review, a final total of 70 articles were included. These included 20 studies focussing on subjective sleep, 14 on RBD, 8 on EDS, 7 on objective sleep, and 1 on circadian rhythms. The majority of the 18 treatment studies used pharmacological interventions (n = 12), had an open-label design (n = 8), and were of low-to-moderate quality. Most studies (n = 55) included only patients with DLB. Due to the heterogeneity of the studies, we reported a narrative synthesis without meta-analysis. Conclusions: At least one form of sleep disturbance may be present in as many as 90% of people with LBD. Subjectively poor sleep quality, excessive daytime sleepiness, and RBD are more common and severe in LBD relative to other dementias.

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Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer’s Disease, and Normal Aging

Cited by 45 publications

References 35 publications

Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients

Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients

Brain rhythm attractor breakdown in Alzheimer's disease: Functional and pathologic implications

Sleep disturbances in Lewy body dementia: A systematic review

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