Grace J B, Walker M P, McKeith I G
Lecturer in Psychiatry, Department of Old Age Psychiatry, Wolfson Research Unit, Newcastle General Hospital, Newcastle upon Tyne, UK.
Int J Geriatr Psychiatry. 2000 Nov;15(11):1028-33. doi: 10.1002/1099-1166(200011)15:11<1028::aid-gps227>3.0.co;2-e.
Sleep disturbances are common in healthy old age and in dementia syndromes. Polysomnography has demonstrated typical changes in both Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) with AD being characterised by sundowning and sleep apnoea and DLB patients showing more disturbances of movement control during sleep. The technical difficulties associated with EEG sleep recordings mean that polysomnography is not possible out of specialist centres.
To use questionnaires to assess the frequency of sleep disturbances in patients with Alzheimer's disease and dementia with Lewy bodies.
The sleep profiles of twenty patients with AD and 17 with DLB were assessed using three questionnaires, one designed to assess night time sleep disturbance, one day time sleepiness and the last carer burden. The sleep questionnaires were repeated in a subgroup after treatment with a cholinesterase inhibitor (rivastigmine).
Level of sleep disturbance in both groups was high. DLB patients had more overall sleep disturbance, more movement disorders whilst asleep and more abnormal day time sleepiness. Treatment with rivastigmine produced a trend towards normalisation of sleep profile in a small number of subjects.
Both groups have extensive sleep problems. The DLB and AD groups have different sleep profiles that are of diagnostic importance and may suggest different treatment strategies. The results are consistent with those found from polysomnographic assessment and suggest that the questionnaires used are sensitive to detect differences previously documented with polysomnography.
睡眠障碍在健康老年人和痴呆综合征中很常见。多导睡眠图已证实阿尔茨海默病（AD）和路易体痴呆（DLB）均有典型变化，AD的特征为日落综合征和睡眠呼吸暂停，而DLB患者在睡眠期间表现出更多运动控制障碍。与脑电图睡眠记录相关的技术难题意味着在专科中心以外无法进行多导睡眠图检查。
使用问卷评估阿尔茨海默病和路易体痴呆患者睡眠障碍的发生率。
使用三份问卷评估20例AD患者和17例DLB患者的睡眠状况，一份用于评估夜间睡眠障碍，一份用于评估日间嗜睡，最后一份用于评估照料者负担。在一组患者接受胆碱酯酶抑制剂（卡巴拉汀）治疗后重复进行睡眠问卷调查。
两组的睡眠障碍程度都很高。DLB患者总体睡眠障碍更多，睡眠时运动障碍更多，日间异常嗜睡更多。卡巴拉汀治疗使少数受试者的睡眠状况有趋于正常化的趋势。
两组均存在广泛的睡眠问题。DLB组和AD组有不同的睡眠状况，具有诊断意义，可能提示不同的治疗策略。结果与多导睡眠图评估结果一致，表明所使用的问卷对于检测先前多导睡眠图记录的差异很敏感。
