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Tom 13, Nr 4 (2017)
Artykuł przeglądowy
Opublikowany online: 2018-01-05
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Zaburzenia snu w chorobie Alzheimera

Mariusz Siemiński
Pol. Przegl. Neurol 2017;13(4):173-185.

dostęp otwarty

Tom 13, Nr 4 (2017)
Artykuły przeglądowe
Opublikowany online: 2018-01-05

Streszczenie

Zaburzenia snu są istotnym, lecz często zaniedbywanym elementem obrazu klinicznego choroby Alzheimera (AD, Alzheimer’s disease). Istnieją przesłanki pozwalające sądzić, że zaburzenia snu (szerzej — zaburzenia rytmu snu i czuwania) mogą promować zjawiska sprzyjające rozwojowi procesu neurodegeneracyjnemu. Natomiast zmiany neuropatologiczne zachodzące w przebiegu choroby mogą prowadzić do zaburzeń rytmu okołodobowego. U chorych z AD współwystępują pierwotne zaburzenia snu. Leki stosowane w terapii AD nie pozostają bez wpływu na sen. Zrozumienie mechanizmów łączących zaburzenia snu z neurodegeneracją może pomóc w planowaniu działań profilaktycznych. Rozpoznanie zaburzeń snu wymaga przede wszystkim zebrania właściwego wywiadu, a w uzasadnionych przypadkach — wykorzystania aktygrafii bądź polisomnografii. Leczenie zaburzeń snu, zaplanowane adekwatnie do rozpoznania, może poprawić stan pacjenta pod względem emocjonalnym, poznawczym i behawioralnym. Lekarz i opiekun pacjenta z AD dysponują różnymi terapeutycznymi metodami farmakologicznymi i niefarmakologicznymi, których umiejętne zastosowanie może przynieść pozytywny efekt.

Streszczenie

Zaburzenia snu są istotnym, lecz często zaniedbywanym elementem obrazu klinicznego choroby Alzheimera (AD, Alzheimer’s disease). Istnieją przesłanki pozwalające sądzić, że zaburzenia snu (szerzej — zaburzenia rytmu snu i czuwania) mogą promować zjawiska sprzyjające rozwojowi procesu neurodegeneracyjnemu. Natomiast zmiany neuropatologiczne zachodzące w przebiegu choroby mogą prowadzić do zaburzeń rytmu okołodobowego. U chorych z AD współwystępują pierwotne zaburzenia snu. Leki stosowane w terapii AD nie pozostają bez wpływu na sen. Zrozumienie mechanizmów łączących zaburzenia snu z neurodegeneracją może pomóc w planowaniu działań profilaktycznych. Rozpoznanie zaburzeń snu wymaga przede wszystkim zebrania właściwego wywiadu, a w uzasadnionych przypadkach — wykorzystania aktygrafii bądź polisomnografii. Leczenie zaburzeń snu, zaplanowane adekwatnie do rozpoznania, może poprawić stan pacjenta pod względem emocjonalnym, poznawczym i behawioralnym. Lekarz i opiekun pacjenta z AD dysponują różnymi terapeutycznymi metodami farmakologicznymi i niefarmakologicznymi, których umiejętne zastosowanie może przynieść pozytywny efekt.
Pobierz cytowanie

Słowa kluczowe

choroba Alzheimera, zaburzenia snu, rytm okołodobowy, neurodegeneracja

Informacje o artykule
Tytuł

Zaburzenia snu w chorobie Alzheimera

Czasopismo

Polski Przegląd Neurologiczny

Numer

Tom 13, Nr 4 (2017)

Typ artykułu

Artykuł przeglądowy

Strony

173-185

Data publikacji on-line

2018-01-05

Rekord bibliograficzny

Pol. Przegl. Neurol 2017;13(4):173-185.

Słowa kluczowe

choroba Alzheimera
zaburzenia snu
rytm okołodobowy
neurodegeneracja

Autorzy

Mariusz Siemiński

Referencje (75)
  1. Hippius H, Neundörfer G. The discovery of Alzheimer's disease. Dialogues Clin Neurosci. 2003; 5(1): 101–108.
  2. Guarnieri B, Adorni F, Musicco M, et al. Prevalence of sleep disturbances in mild cognitive impairment and dementing disorders: a multicenter Italian clinical cross-sectional study on 431 patients. Dement Geriatr Cogn Disord. 2012; 33(1): 50–58.
  3. Little JT, Satlin A, Sunderland T, et al. Sundown syndrome in severely demented patients with probable Alzheimer's disease. J Geriatr Psychiatry Neurol. 1995; 8(2): 103–106.
  4. Volicer L, Harper DG, Manning BC, et al. Sundowning and circadian rhythms in Alzheimer's disease. Am J Psychiatry. 2001; 158(5): 704–711.
  5. Pollak CP, Perlick D, Linsner JP, et al. Sleep problems in the community elderly as predictors of death and nursing home placement. J Community Health. 1990; 15(2): 123–135.
  6. Dale MC, Burns A, Panter L, et al. Factors affecting survival of elderly nursing home residents. Int J Geriatr Psychiatry. 2001; 16(1): 70–76, doi: 10.1002/1099-1166(200101)16:1<70::aid-gps277>3.0.co;2-6.
  7. Moran M, Lynch CA, Walsh C, et al. Sleep disturbance in mild to moderate Alzheimer's disease. Sleep Med. 2005; 6(4): 347–352.
  8. Villa C, Ferini-Strambi L, Combi R. The Synergistic Relationship between Alzheimer's Disease and Sleep Disorders: An Update. J Alzheimers Dis. 2015; 46(3): 571–580.
  9. Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult - a mini-review. Gerontology. 2010; 56(2): 181–189.
  10. Espiritu JR. Aging-related sleep changes. Clin Geriatr Med. 2008; 24(1): 1–14, v.
  11. Ohayon MM, Carskadon MA, Guilleminault C, et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004; 27(7): 1255–1273.
  12. Cho K. Chronic 'jet lag' produces temporal lobe atrophy and spatial cognitive deficits. Nat Neurosci. 2001; 4(6): 567–568.
  13. Peter-Derex L, Yammine P, Bastuji H, et al. Sleep and Alzheimer's disease. Sleep Med Rev. 2015; 19: 29–38.
  14. Schlosser Covell GE, Dhawan PS, Lee Iannotti JK, et al. Disrupted daytime activity and altered sleep-wake patterns may predict transition to mild cognitive impairment or dementia: a critically appraised topic. Neurologist. 2012; 18(6): 426–429.
  15. Lim ASP, Ellison BA, Wang JL, et al. Sleep is related to neuron numbers in the ventrolateral preoptic/intermediate nucleus in older adults with and without Alzheimer's disease. Brain. 2014; 137(Pt 10): 2847–2861.
  16. Nebes RD, Buysse DJ, Halligan EM, et al. Self-reported sleep quality predicts poor cognitive performance in healthy older adults. J Gerontol B Psychol Sci Soc Sci. 2009; 64(2): 180–187.
  17. Keage HA, Banks S, Yang KL, et al. What sleep characteristics predict cognitive decline in the elderly? Sleep Med. 2012; 13(7): 886–892.
  18. Potvin O, Lorrain D, Forget H, et al. Sleep quality and 1-year incident cognitive impairment in community-dwelling older adults. Sleep. 2012; 35(4): 491–499.
  19. Niu J, Han H, Wang Y, et al. Sleep quality and cognitive decline in a community of older adults in Daqing City, China. Sleep Med. 2016; 17: 69–74.
  20. Lim ASP, Kowgier M, Yu L, et al. Sleep Fragmentation and the Risk of Incident Alzheimer's Disease and Cognitive Decline in Older Persons. Sleep. 2013; 36(7): 1027–1032.
  21. Ooms S, Overeem S, Besse K, et al. Effect of 1 night of total sleep deprivation on cerebrospinal fluid β-amyloid 42 in healthy middle-aged men: a randomized clinical trial. JAMA Neurol. 2014; 71(8): 971–977.
  22. Cedernaes J, Osorio RS, Varga AW, et al. Candidate mechanisms underlying the association between sleep-wake disruptions and Alzheimer's disease. Sleep Med Rev. 2017; 31: 102–111.
  23. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013; 342(6156): 373–377.
  24. Di Meco A, Joshi YB, Praticò D. Sleep deprivation impairs memory, tau metabolism, and synaptic integrity of a mouse model of Alzheimer's disease with plaques and tangles. Neurobiol Aging. 2014; 35(8): 1813–1820.
  25. Rothman SM, Herdener N, Frankola KA, et al. Chronic mild sleep restriction accentuates contextual memory impairments, and accumulations of cortical Aβ and pTau in a mouse model of Alzheimer's disease. Brain Res. 2013; 1529: 200–208.
  26. Sultana R, Butterfield D. Role of oxidative stress in the progression of Alzheimer's disease. J Alzheimers Dis. 2010; 19(1): 341–353.
  27. Zhang J, Zhu Y, Zhan G, et al. Extended wakefulness: compromised metabolics in and degeneration of locus ceruleus neurons. J Neurosci. 2014; 34(12): 4418–4431.
  28. Silva RH, Abílio VC, Takatsu AL, et al. Role of hippocampal oxidative stress in memory deficits induced by sleep deprivation in mice. Neuropharmacology. 2004; 46(6): 895–903.
  29. He J, Hsuchou H, He Yi, et al. Sleep restriction impairs blood-brain barrier function. J Neurosci. 2014; 34(44): 14697–14706.
  30. Winkler EA, Nishida Y, Sagare AP, et al. GLUT1 reductions exacerbate Alzheimer's disease vasculo-neuronal dysfunction and degeneration. Nat Neurosci. 2015; 18(4): 521–530.
  31. Coogan AN, Schutová B, Husung S, et al. The circadian system in Alzheimer's disease: disturbances, mechanisms, and opportunities. Biol Psychiatry. 2013; 74(5): 333–339.
  32. Stopa EG, Volicer L, Kuo-Leblanc V, et al. Pathologic evaluation of the human suprachiasmatic nucleus in severe dementia. J Neuropathol Exp Neurol. 1999; 58(1): 29–39.
  33. Harper DG, Stopa EG, McKee AC, et al. Dementia severity and Lewy bodies affect circadian rhythms in Alzheimer disease. Neurobiol Aging. 2004; 25(6): 771–781.
  34. Harper DG, Stopa EG, Kuo-Leblanc V, et al. Dorsomedial SCN neuronal subpopulations subserve different functions in human dementia. Brain. 2008; 131(Pt 6): 1609–1617.
  35. Mahlberg R, Walther S, Kalus P, et al. Pineal calcification in Alzheimer's disease: an in vivo study using computed tomography. Neurobiol Aging. 2008; 29(2): 203–209.
  36. Liu RY, Zhou JN, van Heerikhuize J, et al. Decreased melatonin levels in postmortem cerebrospinal fluid in relation to aging, Alzheimer's disease, and apolipoprotein E-epsilon4/4 genotype. J Clin Endocrinol Metab. 1999; 84(1): 323–327.
  37. Zhou JN, Liu RY, Kamphorst W, et al. Early neuropathological Alzheimer's changes in aged individuals are accompanied by decreased cerebrospinal fluid melatonin levels. J Pineal Res. 2003; 35(2): 125–130.
  38. Lahiri DK, Chen D, Ge YW, et al. Dietary supplementation with melatonin reduces levels of amyloid beta-peptides in the murine cerebral cortex. J Pineal Res. 2004; 36(4): 224–231.
  39. Matsubara E, Bryant-Thomas T, Pacheco Quinto J, et al. Melatonin increases survival and inhibits oxidative and amyloid pathology in a transgenic model of Alzheimer's disease. J Neurochem. 2003; 85(5): 1101–1108.
  40. Rose KM, Beck C, Tsai PF, et al. Sleep disturbances and nocturnal agitation behaviors in older adults with dementia. Sleep. 2011; 34(6): 779–786.
  41. Gehrman PR, Martin JL, Shochat T, et al. Sleep-disordered breathing and agitation in institutionalized adults with Alzheimer disease. Am J Geriatr Psychiatry. 2003; 11(4): 426–433.
  42. Djonlagic I, Guo M, Matteis P, et al. Untreated sleep-disordered breathing: links to aging-related decline in sleep-dependent memory consolidation. PLoS One. 2014; 9(1): e85918.
  43. Allen RP, Picchietti DL, Garcia-Borreguero D, et al. International Restless Legs Syndrome Study Group. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med. 2014; 15(8): 860–873.
  44. Klaffke S, Staedt J. Sundowning and circadian rhythm disorders in dementia. Acta Neurol Belg. 2006; 106(4): 168–175.
  45. Etcher L, Whall A, Kumar R, et al. Nonlinear indices of circadian changes in individuals with dementia and aggression. Psychiatry Res. 2012; 199(1): 77–78.
  46. Gallagher-Thompson D, Brooks JO, Bliwise D, et al. The relations among caregiver stress, J Am Geriatr Soc. 1992; 40(8): 807–810.
  47. Kanbayashi T, Sugiyama T, Aizawa R, et al. Effects of donepezil (Aricept) on the rapid eye movement sleep of normal subjects. Psychiatry Clin Neurosci. 2002; 56(3): 307–308.
  48. Tractenberg RE, Singer CM, Cummings JL, et al. The Sleep Disorders Inventory: an instrument for studies of sleep disturbance in persons with Alzheimer's disease. J Sleep Res. 2003; 12(4): 331–337.
  49. Boeve BF, Molano JR, Ferman TJ, et al. Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in a community-based sample. J Clin Sleep Med. 2013; 9(5): 475–480.
  50. Ancoli-Israel S, Clopton P, Klauber MR, et al. Use of wrist activity for monitoring sleep/wake in demented nursing-home patients. Sleep. 1997; 20(1): 24–27.
  51. Paavilainen P, Korhonen I, Lötjönen J, et al. Circadian activity rhythm in demented and non-demented nursing-home residents measured by telemetric actigraphy. J Sleep Res. 2005; 14(1): 61–68.
  52. Kushida CA, Nichols DA, Holmes TH, et al. Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Sleep. 2012; 35(12): 1593–1602.
  53. Rosenzweig I, Glasser M, Crum WR, et al. Changes in Neurocognitive Architecture in Patients with Obstructive Sleep Apnea Treated with Continuous Positive Airway Pressure. EBioMedicine. 2016; 7: 221–229.
  54. Ancoli-Israel S, Palmer BW, Cooke JR, et al. Cognitive effects of treating obstructive sleep apnea in Alzheimer's disease: a randomized controlled study. J Am Geriatr Soc. 2008; 56(11): 2076–2081.
  55. Winkelman JW, Armstrong MJ, Allen RP, et al. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016; 87(24): 2585–2593.
  56. Stoner SC, Dahmen MM, Makos M, et al. An exploratory retrospective evaluation of ropinirole-associated psychotic symptoms in an outpatient population treated for restless legs syndrome or Parkinson's disease. Ann Pharmacother. 2009; 43(9): 1426–1432.
  57. Singer C, Tractenberg RE, Kaye J, et al. Alzheimer's Disease Cooperative Study. A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease. Sleep. 2003; 26(7): 893–901.
  58. Wade AG, Farmer M, Harari G, et al. Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer's disease: a 6-month, randomized, placebo-controlled, multicenter trial. Clin Interv Aging. 2014; 9: 947–961.
  59. Gehrman PR, Connor DJ, Martin JL, et al. Melatonin fails to improve sleep or agitation in double-blind randomized placebo-controlled trial of institutionalized patients with Alzheimer disease. Am J Geriatr Psychiatry. 2009; 17(2): 166–169.
  60. McCleery J, Cohen DA, Sharpley AL. Pharmacotherapies for sleep disturbances in Alzheimer's disease. Cochrane Database Syst Rev. 2014(3): CD009178.
  61. Zhang W, Chen Xy, Su Sw, et al. Exogenous melatonin for sleep disorders in neurodegenerative diseases: a meta-analysis of randomized clinical trials. Neurol Sci. 2016; 37(1): 57–65.
  62. Defrancesco M, Marksteiner J, Fleischhacker WW, et al. Use of Benzodiazepines in Alzheimer's Disease: A Systematic Review of Literature. Int J Neuropsychopharmacol. 2015; 18(10): pyv055.
  63. Yin Y, Liu Y, Zhuang J, et al. Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances. Pharmacology. 2015; 96(3-4): 155–162.
  64. Meguro K, Meguro M, Tanaka Y, et al. Risperidone is effective for wandering and disturbed sleep/wake patterns in Alzheimer's disease. J Geriatr Psychiatry Neurol. 2004; 17(2): 61–67.
  65. Wirz-Justice A, Werth E, Savaskan E, et al. Haloperidol disrupts, clozapine reinstates the circadian rest-activity cycle in a patient with early-onset Alzheimer disease. Alzheimer Dis Assoc Disord. 2000; 14(4): 212–215.
  66. Savaskan E, Schnitzler C, Schröder C, et al. Treatment of behavioural, cognitive and circadian rest-activity cycle disturbances in Alzheimer's disease: haloperidol vs. quetiapine. Int J Neuropsychopharmacol. 2006; 9(5): 507–516.
  67. Alessi CA, Martin JL, Webber AP, et al. Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. J Am Geriatr Soc. 2005; 53(5): 803–810.
  68. Richards KC, Beck C, O'Sullivan PS, et al. Effect of individualized social activity on sleep in nursing home residents with dementia. J Am Geriatr Soc. 2005; 53(9): 1510–1517.
  69. Figueiro MG, Plitnick BA, Lok A, et al. Tailored lighting intervention improves measures of sleep, depression, and agitation in persons with Alzheimer's disease and related dementia living in long-term care facilities. Clin Interv Aging. 2014; 9: 1527–1537.
  70. Burns A, Allen H, Tomenson B, et al. Bright light therapy for agitation in dementia: a randomized controlled trial. Int Psychogeriatr. 2009; 21(4): 711–721.
  71. Dowling GA, Burr RL, Van Someren EJW, et al. Melatonin and bright-light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease. J Am Geriatr Soc. 2008; 56(2): 239–246.
  72. McCurry SM, Pike KC, Vitiello MV, et al. Increasing walking and bright light exposure to improve sleep in community-dwelling persons with Alzheimer's disease: results of a randomized, controlled trial. J Am Geriatr Soc. 2011; 59(8): 1393–1402.
  73. Moraes Wd, Poyares DR, Guilleminault C, et al. The effect of donepezil on sleep and REM sleep EEG in patients with Alzheimer disease: a double-blind placebo-controlled study. Sleep. 2006; 29(2): 199–205.
  74. Moraes W, Poyares D, Sukys-Claudino L, et al. Donepezil improves obstructive sleep apnea in Alzheimer disease: a double-blind, placebo-controlled study. Chest. 2008; 133(3): 677–683.
  75. Ishikawa I, Shinno H, Ando N, et al. The effect of memantine on sleep architecture and psychiatric symptoms in patients with Alzheimer's disease. Acta Neuropsychiatr. 2016; 28(3): 157–164.

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