Service de Neurologie-sommeil, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69310 Pierre-Benite, France; Intégration centrale de la douleur chez l'homme, Centre de recherche en Neurosciences de Lyon, CNRS UMR 5292, INSERM U 1028, Université Lyon 1, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
Centre Hospitalier du Nord, Liban-Nord, Jdeidet Zgharta, B.P.100, Lebanon.
Sleep Med Rev. 2015 Feb;19:29-38. doi: 10.1016/j.smrv.2014.03.007. Epub 2014 Apr 3.
Sleep disorders are frequent in Alzheimer's disease (AD), with a significant impact on patients and caregivers and a major risk factor for early institutionalization. Micro-architectural sleep alterations, nocturnal sleep fragmentation, decrease in nocturnal sleep duration, diurnal napping and even inversion of the sleep-wake cycle are the main disorders observed in patients with AD. Experimental and epidemiological evidence for a close reciprocal interaction between cognitive decline and sleep alterations is growing. Management of sleep disorders in AD is pre-eminently behavioral. Association of melatonin and bright light treatment seems to be promising as well. The presence of sleep complaints, especially excessive somnolence in demented patients, should draw attention to possible associated sleep pathologies such as sleep apnea syndrome or restless legs syndrome.
睡眠障碍在阿尔茨海默病(AD)中很常见,对患者和护理人员有重大影响,也是导致早期住院的主要风险因素。微结构睡眠改变、夜间睡眠碎片化、夜间睡眠时间减少、日间小睡甚至睡眠-觉醒周期颠倒,这些是 AD 患者主要观察到的睡眠障碍。认知能力下降和睡眠改变之间存在密切相互作用的实验和流行病学证据正在不断增加。AD 患者睡眠障碍的管理主要是行为上的。褪黑素和亮光治疗的联合似乎也很有前景。痴呆患者出现睡眠主诉,特别是过度嗜睡,应引起对可能存在的相关睡眠病理的关注,如睡眠呼吸暂停综合征或不宁腿综合征。