Chwiszczuk Luiza, Breitve Monica, Hynninen Minna, Gjerstad Michaela D, Aarsland Dag, Rongve Arvid
Department of Neurology, Haugesund Hospital, Haugesund, Norway.
Neurodegener Dis. 2016;16(3-4):152-60. doi: 10.1159/000439252. Epub 2015 Nov 10.
Sleep disturbances (SDs) are common in patients with all forms of dementia. However, most studies focus on Alzheimer's disease (AD) and less is known about the prevalence and characteristics of SD in dementia with Lewy bodies (DLB).
The aims of this cross-sectional study were: (1) to examine the frequency of SD in DLB versus AD; (2) to compare patients with and without SD with regard to relevant clinical variables, and (3) to investigate the associations between SD and medication use.
Patients with a first-time diagnosis of probable or possible DLB or AD were selected from the Dementia Study of Western Norway and recruited from clinics for old age psychiatry from 2010 until the end of 2013.
In all, 123 (55.7%) subjects with dementia suffered from at least one SD. Insomnia was present in 77 (34.8%), and 34 (20.7%) patients had probable REM-sleep behaviour disorder (RBD). All SDs were also significantly more frequent in patients with DLB than in AD, and DLB patients also more often had several co-occurring SDs. The presence of any SD was associated with more neuropsychiatric symptoms, higher morbidity, more parkinsonian symptoms and excessive daytime sleepiness. Antiparkinsonian medication was used more often in RBD, restless leg syndrome (RLS) and periodic limb movements, and benzodiazepines were also common in RLS.
Sleep problems are more common in DLB patients compared to AD, and are associated with more clinical impairment. DLB patients frequently have several sleep problems occurring simultaneously, which suggests a need for screening and accurate assessment of sleep in DLB.
睡眠障碍（SDs）在所有形式的痴呆患者中都很常见。然而，大多数研究集中在阿尔茨海默病（AD），而关于路易体痴呆（DLB）中SD的患病率和特征了解较少。
这项横断面研究的目的是：（1）检查DLB与AD中SD的频率；（2）比较有和没有SD的患者在相关临床变量方面的情况，以及（3）研究SD与药物使用之间的关联。
从挪威西部痴呆研究中选取首次诊断为可能或疑似DLB或AD的患者，并于2010年至2013年底从老年精神病诊所招募。
总共有123名（55.7%）痴呆患者患有至少一种SD。77名（34.8%）存在失眠，34名（20.7%）患者可能患有快速眼动睡眠行为障碍（RBD）。所有SD在DLB患者中也比在AD患者中明显更频繁，并且DLB患者也更常同时出现几种SD。任何SD的存在都与更多的神经精神症状、更高的发病率、更多的帕金森症状和日间过度嗜睡有关。抗帕金森药物在RBD、不宁腿综合征（RLS）和周期性肢体运动中使用更频繁，苯二氮䓬类药物在RLS中也很常见。
与AD相比，睡眠问题在DLB患者中更常见，并且与更多的临床损害相关。DLB患者经常同时出现几种睡眠问题，这表明需要对DLB患者的睡眠进行筛查和准确评估。
