Matterson Ellie, Wilson-Menzfeld Gemma, Olsen Kirsty, Taylor John-Paul, Elder Greg J
Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK.
Faculty of Health and Life Sciences, Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK.
SAGE Open Med. 2024 Oct 9;12:20503121241271827. doi: 10.1177/20503121241271827. eCollection 2024.
Dementia with Lewy bodies is characterised by rapid fluctuations in attention, which are known as "cognitive fluctuations." Despite the fact that cognitive fluctuations are considered to be a core dementia with Lewy bodies symptom, they are very difficult to define and measure using existing quantitative subjective measurement tools, which are typically completed by caregivers. Cognitive fluctuations are also likely to be influenced by various aspects of sleep, but this is as yet unexplored. The primary aim of this qualitative study was to investigate the phenomenology of cognitive fluctuations in dementia with Lewy bodies by understanding caregiver experiences.
Seven caregivers of people with dementia with Lewy bodies completed one-to-one semistructured interviews, which were conducted by telephone. Caregivers were asked to describe the nature, frequency, duration and potential triggers of cognitive fluctuations that were experienced by the individual with dementia with Lewy bodies. Caregivers were also asked about the subjective sleep experience of the individual with dementia with Lewy bodies, and about their own sleep experiences. Interviews were audio recorded, transcribed verbatim and analysed using Thematic Analysis.
Caregivers reported that there was a great deal of individual variation in the frequency, duration and severity of cognitive fluctuations. Patient sleep disturbances, including excessive daytime sleepiness, nocturnal awakenings, restless legs and sleep apnoea, were common. However, the impact of sleep alterations or experiences upon the fluctuations was reported to be less clear. Caregivers also reported that their own sleep was negatively affected, potentially due to actively listening for overnight events and behaviours.
Qualitatively, caregivers report that dementia with Lewy bodies cognitive fluctuations show large individual variations in terms of their frequency, duration and severity, but that subjectively, sleep may not consistently influence this symptom. Specific, caregiver-focussed interventions are likely to be necessary to maintain good sleep health in dementia with Lewy bodies caregivers.
路易体痴呆的特征是注意力快速波动，即所谓的“认知波动”。尽管认知波动被认为是路易体痴呆的核心症状，但使用现有的定量主观测量工具很难对其进行定义和测量，这些工具通常由护理人员完成。认知波动也可能受到睡眠各个方面的影响，但这一点尚未得到探索。这项定性研究的主要目的是通过了解护理人员的经历来调查路易体痴呆中认知波动的现象学。
七名路易体痴呆患者的护理人员完成了一对一的半结构化电话访谈。护理人员被要求描述路易体痴呆患者所经历的认知波动的性质、频率、持续时间和潜在触发因素。护理人员还被问及路易体痴呆患者的主观睡眠体验以及他们自己的睡眠体验。访谈进行了录音，逐字转录，并使用主题分析法进行分析。
护理人员报告说，认知波动的频率、持续时间和严重程度存在很大的个体差异。患者的睡眠障碍很常见，包括白天过度嗜睡、夜间觉醒、不安腿和睡眠呼吸暂停。然而，据报告，睡眠改变或体验对波动的影响不太明确。护理人员还报告说，他们自己的睡眠受到了负面影响，这可能是由于积极倾听夜间事件和行为所致。
从定性角度来看，护理人员报告说，路易体痴呆的认知波动在频率、持续时间和严重程度方面存在很大的个体差异，但主观上，睡眠可能不会始终如一地影响这一症状。可能需要针对护理人员的特定干预措施，以维持路易体痴呆护理人员的良好睡眠健康状况。
