Northumbria Sleep Research, Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Sleep and Brain Research Unit, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
Int J Geriatr Psychiatry. 2022 Oct;37(10). doi: 10.1002/gps.5814.
Lewy body dementia (LBD) refers to both dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). Sleep disturbances are common in LBD, and can include poor sleep quality, excessive daytime sleepiness (EDS), and rapid eye movement behaviour disorder (RBD). Despite the high clinical prevalence of sleep disturbances in LBD, they are under-studied relative to other dementias. The aim of the present systematic review was to examine the nature of sleep disturbances in LBD, summarise the effect of treatment studies upon sleep, and highlight specific and necessary directions for future research.
Published studies in English were located by searching PubMED and PSYCArticles databases (until 10 June 2022). The search protocol was pre-registered in PROSPERO (CRD42021293490) and performed in accordance with PRISMA guidelines.
Following full-text review, a final total of 70 articles were included. These included 20 studies focussing on subjective sleep, 14 on RBD, 8 on EDS, 7 on objective sleep, and 1 on circadian rhythms. The majority of the 18 treatment studies used pharmacological interventions (n = 12), had an open-label design (n = 8), and were of low-to-moderate quality. Most studies (n = 55) included only patients with DLB. Due to the heterogeneity of the studies, we reported a narrative synthesis without meta-analysis.
At least one form of sleep disturbance may be present in as many as 90% of people with LBD. Subjectively poor sleep quality, excessive daytime sleepiness, and RBD are more common and severe in LBD relative to other dementias.
路易体痴呆（LBD）既指路易体痴呆（DLB），也指帕金森病伴痴呆（PDD）。睡眠障碍在 LBD 中很常见，包括睡眠质量差、白天过度嗜睡（EDS）和快速眼动行为障碍（RBD）。尽管 LBD 中睡眠障碍的临床患病率很高，但相对于其他痴呆症，它们的研究相对较少。本系统评价的目的是检查 LBD 中睡眠障碍的性质，总结治疗研究对睡眠的影响，并强调未来研究的具体和必要方向。
通过搜索 PubMED 和 PSYCArticles 数据库（截至 2022 年 6 月 10 日），以英文发表的研究。搜索方案已在 PROSPERO（CRD42021293490）中预先注册，并按照 PRISMA 指南进行。
经过全文审查，最终共纳入 70 篇文章。其中包括 20 项关于主观睡眠的研究、14 项关于 RBD 的研究、8 项关于 EDS 的研究、7 项关于客观睡眠的研究和 1 项关于昼夜节律的研究。18 项治疗研究中，大多数使用了药物干预（n=12），有 8 项采用开放标签设计（n=8），且质量为低到中等。大多数研究（n=55）仅包括 DLB 患者。由于研究的异质性，我们报告了叙述性综述，而没有进行荟萃分析。
至少有一种形式的睡眠障碍可能存在于多达 90%的 LBD 患者中。与其他痴呆症相比，主观睡眠质量差、白天过度嗜睡和 RBD 在 LBD 中更为常见和严重。
