Sleep Medicine Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy.
Neurology Unit, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy.
J Alzheimers Dis. 2020;74(2):501-508. doi: 10.3233/JAD-191124.
Alzheimer's disease (AD) is the most common form of dementia. It is mainly characterized by a progressive deterioration of cognition, but sleep-wake cycle disturbances frequently occur. Irregular sleep-wake cycle, insomnia, and daytime napping usually occur in patients with AD in the course of the disease.
The aim of the present study was to verify the sleep-wake cycle in mild to moderate AD patients compared to controls, and to evaluate the relationship between the sleep-wake cycle impairment and the neuropsychological testing, CSF AD biomarkers, and CSF orexin concentrations.
Mild to moderate AD patients were enrolled and underwent 14-day actigraphic recording, sleep diary, neuropsychological testing, and CSF biomarkers analysis. All patients were compared to controls.
Eighteen AD patients were compared to ten controls. AD patients showed the alteration of the sleep-wake cycle, featured by sleep dysregulation and daytime wake fragmentation, with respect to controls. Considering the correlation analysis, we documented the correlation between tau proteins and orexin CSF levels and sleep-wake cycle dysregulation.
This study confirmed the dysregulation of sleep-wake cycle in AD patients, as reflected by the daytime wake fragmentation, irregular sleep-wake rhythm, and nocturnal sleep impairment. This sleep-wake cycle disorder correlates with AD neuropathological in vivo features and brain orexin activity. Hence, we suppose that a more marked AD pathology coupled with orexinergic system dysregulation may promote sleep-wake cycle impairment in AD patients.
阿尔茨海默病（AD）是最常见的痴呆症形式。它主要表现为认知功能的进行性恶化，但睡眠-觉醒周期紊乱经常发生。在疾病过程中，AD 患者通常会出现不规则的睡眠-觉醒周期、失眠和白天小睡。
本研究旨在验证轻度至中度 AD 患者与对照组之间的睡眠-觉醒周期，并评估睡眠-觉醒周期障碍与神经心理学测试、CSF AD 生物标志物和 CSF 食欲素浓度之间的关系。
招募轻度至中度 AD 患者并进行 14 天的活动记录仪记录、睡眠日记、神经心理学测试和 CSF 生物标志物分析。所有患者均与对照组进行比较。
18 名 AD 患者与 10 名对照组进行了比较。与对照组相比，AD 患者表现出睡眠-觉醒周期的改变，表现为睡眠失调和白天觉醒碎片化。考虑到相关分析，我们记录了 Tau 蛋白和食欲素 CSF 水平与睡眠-觉醒周期失调之间的相关性。
本研究证实了 AD 患者睡眠-觉醒周期的失调，表现为白天觉醒碎片化、不规则的睡眠-觉醒节律和夜间睡眠障碍。这种睡眠-觉醒周期障碍与 AD 的神经病理学体内特征和大脑食欲素活性相关。因此，我们假设更明显的 AD 病理学加上食欲素能系统失调可能会促进 AD 患者的睡眠-觉醒周期障碍。
