Department of Medical Clinical, Geriatric Medical Centre, HUB, Brasilia University Hospital, SGAN 605 Av. L2 Norte, Asa Norte, Brasilia, DF, CEP 70840-901, Brazil.
Sleep Med Rev. 2013 Dec;17(6):475-88. doi: 10.1016/j.smrv.2013.01.006. Epub 2013 May 10.
Sleep disorders are common in patients with Alzheimer's disease (AD). An important aspect of intervention studies in patients with sleep disorders is the choice of assessment strategy. This paper presents a literature review concerning assessment strategies for measuring sleep in intervention studies with AD patients, with a focus on actigraphy. Thirty-seven articles were selected for this review, having analysis of sleep/nocturnal rhythm disturbances by actigraphy as the primary or secondary outcome. The advantages and limitations of actigraphy were discussed vis-à-vis polysomnography and subjective interventions. The following methodological aspects were addressed: impact of experimental design and patient setting, inclusion and exclusion criteria, placement of the actigraphy device, adherence to the regimen, duration of recordings and the choice of sleep parameters. Our analyses suggest that the methods used in intervention studies encompassing sleep disorders and dementia could be improved by increasing accuracy of diagnosis, categorization of sleep disturbances, adherence to actigraphy, and by clearly defining the variables and endpoints in each study. Also, controlling variables that could interfere with sleep and describing the data processing and analysis might improve interpretation of results.
睡眠障碍在阿尔茨海默病（AD）患者中很常见。在睡眠障碍患者的干预研究中，选择评估策略是一个重要方面。本文就 AD 患者干预研究中测量睡眠的评估策略进行了文献回顾，重点介绍了活动记录仪。本文共选取了 37 篇文章进行综述，这些文章主要通过活动记录仪来分析睡眠/夜间节律紊乱，作为主要或次要结果。本文还讨论了活动记录仪相对于多导睡眠图和主观干预的优缺点。文中还探讨了以下方法学方面的问题：实验设计和患者环境的影响、纳入和排除标准、活动记录仪的放置、对方案的遵守情况、记录的持续时间以及睡眠参数的选择。我们的分析表明，通过提高诊断准确性、对睡眠障碍进行分类、提高对活动记录仪的依从性，并在每项研究中明确定义变量和终点，可以改进包含睡眠障碍和痴呆症的干预研究中使用的方法。此外，控制可能干扰睡眠的变量，并描述数据处理和分析，可能有助于更好地解释结果。
