Kuang Huang, Zhu Yu-Ge, Zhou Zhi-Feng, Yang Mei-Wen, Hong Fen-Fang, Yang Shu-Long
Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China.
Department of Nurse, Nanchang University Hospital, Nanchang, Jiangxi Province, China.
Neural Regen Res. 2021 Oct;16(10):1965-1972. doi: 10.4103/1673-5374.308071.
Sleep disorders are common in patients with Alzheimer's disease, and can even occur in patients with amnestic mild cognitive impairment, which appears before Alzheimer's disease. Sleep disorders further impair cognitive function and accelerate the accumulation of amyloid-β and tau in patients with Alzheimer's disease. At present, sleep disorders are considered as a risk factor for, and may be a predictor of, Alzheimer's disease development. Given that sleep disorders are encountered in other types of dementia and psychiatric conditions, sleep-related biomarkers to predict Alzheimer's disease need to have high specificity and sensitivity. Here, we summarize the major Alzheimer's disease-specific sleep changes, including abnormal non-rapid eye movement sleep, sleep fragmentation, and sleep-disordered breathing, and describe their ability to predict the onset of Alzheimer's disease at its earliest stages. Understanding the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer's disease. This paper therefore explores some potential mechanisms that may contribute to sleep disorders, including dysregulation of the orexinergic, glutamatergic, and γ-aminobutyric acid systems and the circadian rhythm, together with amyloid-β accumulation. This review could provide a theoretical basis for the development of drugs to treat Alzheimer's disease based on sleep disorders in future work.
睡眠障碍在阿尔茨海默病患者中很常见，甚至在早于阿尔茨海默病出现的遗忘型轻度认知障碍患者中也会发生。睡眠障碍会进一步损害认知功能，并加速阿尔茨海默病患者淀粉样蛋白β和tau蛋白的积累。目前，睡眠障碍被认为是阿尔茨海默病发展的一个风险因素，并且可能是其预测指标。鉴于在其他类型的痴呆症和精神疾病中也会出现睡眠障碍，用于预测阿尔茨海默病的睡眠相关生物标志物需要具有高特异性和高敏感性。在此，我们总结了阿尔茨海默病特有的主要睡眠变化，包括异常的非快速眼动睡眠、睡眠片段化和睡眠呼吸紊乱，并描述了它们在阿尔茨海默病最早阶段预测发病的能力。如果我们要阐明睡眠在阿尔茨海默病中的作用，了解这些睡眠变化背后的机制也至关重要。因此，本文探讨了一些可能导致睡眠障碍的潜在机制，包括食欲素能、谷氨酸能和γ-氨基丁酸系统以及昼夜节律的失调，以及淀粉样蛋白β的积累。这篇综述可为未来基于睡眠障碍开发治疗阿尔茨海默病的药物提供理论依据。
