Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia

被引：83

作者：

Guarnieri, Biancamaria ^{[1
]}

Sorbi, Sandro ^{[2
]}

机构：

[1] Villa Serena Hosp, Ctr Sleep Med, IT-65013 Pescara, Italy

[2] Univ Florence, Psychol Drug Res & Child Hlth NEUROFARBA, Dept Neurosci, Florence, Italy

来源：

EUROPEAN NEUROLOGY | 2015年 / 74卷 / 1-2期

关键词：

Sleep disorders; Hypersomnolence; Circadian rhythm sleep disorders; Sleep disordered breathing; Parasomnias; Restless legs syndrome; Dementia; Sleep recommendations; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; BEHAVIOR DISORDER; OLDER WOMEN; WAKE CYCLE; RISK; DISTURBANCES; OREXIN; BRAIN; APNEA;

D O I：

10.1159/000434629

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Sleep disturbances and disruption of the neural regulation of the sleep-wake rhythm appear to be involved in the cellular and molecular mechanisms of cognitive decline. Although sleep problems are highly prevalent in mild cognitive impairment (MCI) and many types of dementia, they have not been systematically investigated in the clinical setting and are often only investigated by sleep specialists upon individual request. Summary: This review discusses sleep disorders in the context of cognitive decline and provides an overview of the clinical diagnosis and management of these disorders in patients with dementia and MCI. Key Messages: Sleep disorders are largely underestimated and do not receive sufficient attention in the global management of dementia patients. Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression. They are positively associated with the severity of behavioral problems and cognitive impairment. Clinical Implications: The recent recommendations by the Sleep Study Group of the Italian Dementia Research Association can be used as a guideline for the clinical assessment and management of sleep disorders in MCI and dementia patients. Sleep disorders should be carefully investigated using an in-depth sleep history, physical examination, questionnaires and clinical scales and should be validated with the support of a direct caregiver. The recommendations for older adults can be used as a framework to guide the diagnosis and treatment of sleep disorders in individuals with dementia and MCI. The management strategy should be based on the choice of different treatments for each sleep problem present in the same patient, while avoiding adverse interactions between treatments. (C) 2015 S. Karger AG, Basel

引用

页码：43 / 48

页数：6

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