Oka Yasunori
Center for Sleep Medicine, Ehime University Hospital.
Rinsho Shinkeigaku. 2014;54(12):994-6. doi: 10.5692/clinicalneurol.54.994.
Sleep disturbance is common in patients with dementia. Circadian rhythm sleep disorders are caused by the disturbance of sleep-wake regulation in the central nervous system, disturbed input into the sensory organs, and decreased social activities. Diurnal change of serum melatonin level in Alzheimer's disease showed decreased amplitude and shifted peak secretion. Age related sleep disturbances and sleep disorders due to the neurodegeneration including REM sleep behavior disorder also increase in dementia. Identifying and treating underlying sleep disorders along with therapeutic approach to circadian mechanism is effective. Treatment of circadian abnormality in dementia require light therapy and increased daytime activity. Use of oral melatonin is also effective for the improvement of nocturnal sleep. Treatment of sleep problems in dementia also contribute to the better management of dementia.
睡眠障碍在痴呆患者中很常见。昼夜节律睡眠障碍是由中枢神经系统中睡眠-觉醒调节的紊乱、感觉器官输入的紊乱以及社交活动减少引起的。阿尔茨海默病患者血清褪黑素水平的昼夜变化显示振幅降低且分泌峰值偏移。与年龄相关的睡眠障碍以及由神经退行性变引起的睡眠障碍(包括快速眼动睡眠行为障碍)在痴呆中也会增加。识别并治疗潜在的睡眠障碍以及针对昼夜节律机制的治疗方法是有效的。治疗痴呆中的昼夜节律异常需要光疗和增加白天活动。口服褪黑素对改善夜间睡眠也有效。治疗痴呆中的睡眠问题也有助于更好地管理痴呆。