Subjectively reported sleep quality and excessive daytime somnolence in Parkinson's disease with and without dementia, dementia with Lewy bodies and Alzheimer's disease

Boddy, F.A.; Rowan, Elise; Lett, Debbie; O’Brien, John T.; McKeith, Ian G.; Burn, David J.

doi:10.1002/gps.1709

Cited by 107 publications

(75 citation statements)

References 37 publications

(41 reference statements)

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“…Sleep problems were more common in DLB compared to AD patients, with more complex SD profiles and several problems occurring simultaneously. This is consistent with previous studies [10,11,13]. A significantly larger group of patients with DLB had three or more SDs in comparison with the AD subjects.…”

Section: Discussionsupporting

confidence: 82%

“…So far, there have only been a few studies that systematically compare SDs in AD and DLB [10,11,12,13]. The main differences found are an increased severity of SD and a higher frequency of REM sleep behaviour disorder (RBD) and other nocturnal problems, such as restless leg syndrome (RLS), periodic limb movements (PLMS) and sleepwalking (SW), in DLB.…”

Section: Introductionmentioning

confidence: 99%

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Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

et al. 2015

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Background: Sleep disturbances (SDs) are common in patients with all forms of dementia. However, most studies focus on Alzheimer's disease (AD) and less is known about the prevalence and characteristics of SD in dementia with Lewy bodies (DLB). Objective: The aims of this cross-sectional study were: (1) to examine the frequency of SD in DLB versus AD; (2) to compare patients with and without SD with regard to relevant clinical variables, and (3) to investigate the associations between SD and medication use. Methods: Patients with a first-time diagnosis of probable or possible DLB or AD were selected from the Dementia Study of Western Norway and recruited from clinics for old age psychiatry from 2010 until the end of 2013. Results: In all, 123 (55.7%) subjects with dementia suffered from at least one SD. Insomnia was present in 77 (34.8%), and 34 (20.7%) patients had probable REM-sleep behaviour disorder (RBD). All SDs were also significantly more frequent in patients with DLB than in AD, and DLB patients also more often had several co-occurring SDs. The presence of any SD was associated with more neuropsychiatric symptoms, higher morbidity, more parkinsonian symptoms and excessive daytime sleepiness. Antiparkinsonian medication was used more often in RBD, restless leg syndrome (RLS) and periodic limb movements, and benzodiazepines were also common in RLS. Conclusions: Sleep problems are more common in DLB patients compared to AD, and are associated with more clinical impairment. DLB patients frequently have several sleep problems occurring simultaneously, which suggests a need for screening and accurate assessment of sleep in DLB.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

et al. 2015

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“…The data thus confirm what preliminary analyses in much smaller samples of such patients from particular sites [15,16,17,18,19] and of patients with more generally defined parkinsonism [20] have demonstrated previously. Patients with DLB are more likely to suffer from NSD than patients with AD.…”

Section: Discussionsupporting

confidence: 77%

Sleep Disturbance in Dementia with Lewy Bodies and Alzheimer’s Disease: A Multicenter Analysis

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Mercaldo

Avidan

et al. 2011

Dement Geriatr Cogn Disord

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Background/Aims: Evidence suggests that patients with dementia with Lewy bodies (DLB) may have more nocturnal sleep disturbance than patients with Alzheimer’s disease (AD). We sought to confirm such observations using a large, prospectively collected, standardized, multicenter-derived database, i.e. the National Alzheimer’s Coordinating Center Uniform Data Set. Methods: Nocturnal sleep disturbance (NSD) data, as characterized by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were derived from 4,531 patients collected between September 2005 and November 2008 from 32 National Institute on Aging participating AD centers. Patient and informant characteristics were compared between those with and without NSD by dementia diagnosis (DLB and probable AD). Finally, a logistic regression model was created to quantify the association between NSD status and diagnosis while adjusting for these patient/informant characteristics, as well as center. Results: NSD was more frequent in clinically diagnosed DLB relative to clinically diagnosed AD (odds ratio = 2.93, 95% confidence interval = 2.22–3.86). These results were independent from the gender of the patient or informant, whether the informant lived with the patient, and other patient characteristics, such as dementia severity, depressive symptoms, and NPI-Q-derived measures of hallucinations, delusions, agitation and apathy. In AD, but not DLB, patients, NSD was associated with more advanced disease. Comorbidity of NSD with hallucinations, agitation and apathy was higher in DLB than in AD. There was also evidence that the percentage of DLB cases with NSD showed wide variation across centers. Conclusion: As defined by the NPI-Q, endorsement of the nocturnal behavior item by informants is more likely in patients with DLB when compared to AD, even after the adjustment of key patient/informant characteristics.

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“…1 Excessive daytime sleepiness (EDS) is a common manifestation of multiple system atrophy (MSA) [2][3][4] and Lewy body disorders, including dementia with Lewy bodies (DLB). [5][6][7] In both MSA and Lewy body disorders, there is loss of several neuronal groups involved in maintenance of the waken state, including cholinergic neurons of the mesopontine tegmentum, 8 noradrenergic neurons in the locus ceruleus, 9 serotonergic neurons of the rostral raphe, 9,10 and hypocretin/orexin neurons of the lateral hypothalamus. [11][12][13] However, involvement of putative wake-active dopaminergic groups in the ventral PAG has not yet been explored in MSA or DLB.…”

mentioning

confidence: 99%

“…This is consistent with the evidence that sleep apnea is an important cause of EDS in MSA 2-4 and DLB. [5][6][7] Furthermore, both MSA and LBD are associated with loss of other wake-active neuronal groups in the hypothalamus and brainstem, including cholinergic mesopontine, 8 noradrenergic locus ceruleus, 9 serotonergic raphe, 9,10 and hypocretin/orexin lateral hypothalamic [11][12][13] neurons. Our findings indicate that, in both MSA and LBD, there is loss of putative wake-active dopaminergic neurons in the ventral PAG.…”

mentioning

confidence: 99%

Dopamine cell loss in the periaqueductal gray in multiple system atrophy and Lewy body dementia

et al. 2009

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Subjectively reported sleep quality and excessive daytime somnolence in Parkinson's disease with and without dementia, dementia with Lewy bodies and Alzheimer's disease

Abstract: EDS and poor sleep quality are greater in PD, PDD and DLB, compared with AD. The dissociation of EDS and motor phenotype suggests their pathophysiology is anatomically and/or temporally distinct.

Cited by 107 publications

References 37 publications

Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

Sleep Disturbance in Dementia with Lewy Bodies and Alzheimer’s Disease: A Multicenter Analysis

Dopamine cell loss in the periaqueductal gray in multiple system atrophy and Lewy body dementia

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