Mishima K, Tozawa T, Satoh K, Matsumoto Y, Hishikawa Y, Okawa M
Department of Neuropsychiatry, Akita University School of Medicine, Japan.
Biol Psychiatry. 1999 Feb 15;45(4):417-21. doi: 10.1016/s0006-3223(97)00510-6.
There is growing evidence that the dysregulation of circadian rhythms may play an important role in irregular sleep-waking in demented elderly. In this study, we investigated daily variation of the pineal hormone melatonin, which has been reported to possess hypnogenic and synchronizing effects, in patients with senile dementia of Alzheimer's type.
Serum melatonin secretion rhythms in inpatients with senile dementia of Alzheimer's type (SDAT group, n = 10, average age = 75.7 years) with disturbed sleep-waking and nondemented elderly (ND group, n = 10, age = 78.3 years) without clinical sleep disorders in the same facility were monitored under a dim light condition without excessive physical exercise.
The SDAT group showed a significantly higher degree of irregularities in actigraphically recorded rest-activity (R-A) rhythm during the 7-day baseline period compared with the ND group. The SDAT group simultaneously showed significantly reduced amplitude, larger variation of peak times, and diminished amount of total secretion in the melatonin secretion rhythm compared with the ND group. There were significantly positive correlations between the severity of R-A rhythm disorder and the reduced amplitude as well as diminished amount of total melatonin secretion.
The SDAT patients with disturbed sleep-waking possessed melatonin secretion rhythm disorders that may play an important role in irregular sleep-waking in demented elderly.
越来越多的证据表明，昼夜节律失调可能在老年痴呆患者的睡眠-觉醒紊乱中起重要作用。在本研究中，我们调查了阿尔茨海默病型老年痴呆患者褪黑素（一种据报道具有催眠和同步化作用的松果体激素）的每日变化情况。
在同一机构中，对睡眠-觉醒紊乱的阿尔茨海默病型老年痴呆住院患者（SDAT组，n = 10，平均年龄 = 75.7岁）和无临床睡眠障碍的非痴呆老年人（ND组，n = 10，年龄 = 78.3岁）在昏暗灯光条件下且无过度体育锻炼的情况下监测血清褪黑素分泌节律。
与ND组相比，SDAT组在7天基线期活动记录仪记录的静息-活动（R-A）节律的不规则程度显著更高。与ND组相比，SDAT组同时显示褪黑素分泌节律的振幅显著降低、峰值时间变化更大以及总分泌量减少。R-A节律紊乱的严重程度与褪黑素分泌振幅降低以及总分泌量减少之间存在显著正相关。
睡眠-觉醒紊乱的SDAT患者存在褪黑素分泌节律紊乱，这可能在老年痴呆患者的睡眠-觉醒紊乱中起重要作用。
