JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2015, Vol. 29 ›› Issue (2): 1-8.doi: 10.6040/j.issn.1673-3770.0.2014.236

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Clinical investigation of sleep disorders and related factors in Alzheimer's disease

HE Ying-xue1, CONG Lin2, DU Yi-feng2   

  1. 1. Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    2. Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2014-07-14 Online:2015-04-16 Published:2015-04-16

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Abstract: Objective To describe the characteristic of sleep disorders in patients with Alzheimer's disease and discuss the relationships between sleep disorder and cognitive function, psychiatric symptoms, living abilities and the caregiver burden. Methods 33 patients with Alzheimer's disease were recruited from clinics of Shandong Provincial Hospital. MMSE was used to measure the cognitive function and the degree of dementia. PSQI and ESS were used to evaluate the sleep disorders of the patients. The data were analyzed with software SPSS version 21.0. Results All items in PSQI occured in AD patients. The most common symptoms were sleep disturbance (57.6%), followed by reduction of sleep efficiency (54.5%) and daytime dysfunction (51.5%), most of which were of mild impairment. The least common item is the using of hypnotic drugs (9.1%). In PSQI, the sleep quality, difficulty falling asleep, sleep time, sleep efficiency were negatively related to MMSE score. In MMSE, orientation, immediate memory, drawing were negatively related to PSQI score. NPI and CSDD scores were both possitively related to PSQI score. Delusion, apathy, sleep/behavior at night and depression were more related to sleep disorders. Patients with sleep disorders had higher ADL and ZBI scores than patients without sleep disorder. Conclusion Various kinds of sleep disorders can occur in the process of Alzheimer's disease. The sleep disorders are closely related to the degree of dementia, cognitive function, living ability and psychiatric symptoms. Also, sleep disorders aggravate the patients' caregiver burden.

Key words: Daytime sleepiness, Epworth sleepiness scale, Sleep disorder, Pittsburgh sleep quality index, Alzheimer's disease

CLC Number: 

  • R741
[1] Chan K Y, Wang W, Wu J J, et al. Epidemiology of Alzheimer's disease and other forms of dementia in China, 1990-2010: a systematic review and analysis[J]. Lancet, 2013, 381(9882):2016-2023.
[2] Qiu C, Kivipelto M, von Strauss E. Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention[J]. Dialogues Clin Neurosci, 2009, 11(2):111-128.
[3] Helzner E P, Scarmeas N, Cosentino S, et al. Survival in Alzheimer disease A multiethnic, population-based study of incident cases[J]. Neurology, 2008, 71(19):1489-1495.
[4] Brookmeyer R, Johnson E, Ziegler-Graham K, et al. Forecasting the global burden of Alzheimer's disease[J]. Alzheimers Dement, 2007, 3(3):186-191.
[5] Alzheimer's Association. 2014 Alzheimer's disease facts and figures[J]. Alzheimers Dement, 2014, 10(2):e47-92.
[6] Moran M, Lynch C A, Walsh C, et al. Sleep disturbance in mild to moderate Alzheimer's disease[J]. Sleep Med, 2005, 6(4):347-352.
[7] McKhann G M, Knopman D S, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease[J]. Alzheimers Dement, 2011, 7(3):263-269.
[8] Folstein M F, Folstein S E, McHigh P R. MiniMental State: a practical method for grading the Cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3):189-198.
[9] 彭丹涛, 许贤豪, 刘江红, 等. 简易智能精神状态检查量表检测老年期痴呆患者的应用探讨[J]. 中国神经免疫学和神经病学杂志, 2005, 12(4):187-190. PENG Dantao, XU Xianhao, LIU Jianghong, et al. Discussion on application of MMSE for senile dementia patients[J]. Chin J Neuroimmunol Neurol, 2005, 12(4):187-190.
[10] Paula J J, Bertola L, Avila R T, et al. Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people[J]. Rev Bras Psiquiatr, 2014, 36(2):143-152.
[11] Kaufer D I, Cummings J L, Ketchel P, et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory[J]. J Neuropsychiatry Clin Neurosci, 2000, 12(2):233-239.
[12] 伍力, 王燕, 李超, 等. 简明神经精神量表中文版在老年痴呆患者中的信效度[J]. 中国心理卫生杂志, 2010 (2):103-107. WU Li, WANG Yan, LI Chao, et al. Reliability and validity of the Chinese version of the Neuropsychiatric Inventory Questionnaire (NPI-Q) in patients with Alzheimer's disease[J]. Chin Ment Health J, 2010 (2):103-107.
[13] Schulze B, Rössler W. Caregiver burden in mental illness: review of measurement, findings and interventions in 2004-2005[J]. Curr Opin Psychiatry, 2005, 18(6):684-691.
[14] Zarit S H, Todd P A, Zarit J M. Subjective burden of husbands and wives as caregivers: a longitudinal study[J]. Gerontologist, 1986, 26(3):260-266.
[15] Johns M W. A new method for measuring daytime sleepiness: the epworth sleepiness scale[J]. Sleep, 1991, 14(6):540-545.
[16] Moore R Y. Suprachiasmatic nucleus in sleep-wake regulation[J]. Sleep Med, 2007, 8(3):27-33.
[17] Edwards B A, O'Driscoll D M, Ali A, et al. Aging and sleep: physiology and pathophysiology[C]. Semin Respir Crit Care Med, 2010, 31(5):618.
[18] Ohayon M M, Carskadon M A, 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[J]. Sleep, 2004, 27(7):1255-1274.
[19] Singer C, Tractenberg R E, Kaye J, et al. A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease[J]. Sleep, 2003, 26(7):893-901.
[20] Ancoli-Israel S, Klauber M R, Gillin J C, et al. Sleep in non-institutionalized Alzheimer's disease patients[J]. Aging (Milano), 1994, 6(6):451-458.
[21] David R, Zeitzer J, Friedman L, et al. Non-pharmacologic management of sleep disturbance in Alzheimer's disease[J]. J Nutr Health Aging, 2010, 14(3):203-206.
[22] Ownby R L, Peruyera G, Acevedo A, et al. Subtypes of Sleep Problems in Patients with Alzheimer Disease[J]. Am J of Geriatr Psychiatry, 2014, 22(2):148-156.
[23] Ju Y E S, McLeland J S, Toedebusch C D, et al. Sleep quality and preclinical Alzheimer disease[J]. JAMA Neuro, 2013, 70(5):587-593.
[24] Diekelmann S, Born J. Memory function of sleep[J]. Nat Rev Neurosci, 2010, 11(2):114-126.
[25] Rauchs G, Schabus M, Parapatics S, et al. Is there a link between sleep changes and memory in Alzheimer's disease?[J]. Neuroreport, 2008, 19(11):1159-1162.
[26] Abel T, Havekes R, Saletin J M, et al. Sleep, plasticity and memory from molecules to whole-brain networks[J]. Curr Biol, 2013, 23(17):774-788.
[27] Di Meco A, Joshi Y B, Praticò D. Sleep deprivation impairs memory, tau metabolism, and synaptic integrity of a mouse model of Alzheimer's disease with plaques and tangles[J]. Neurobiol Aging, 2014, 35(8):1813-1820.
[28] Kendall A P, Kautz M A, Russo M B, et al. Effects of sleep deprivation on lateral visual attention[J]. Int J Neurosci, 2006, 116(10):1125-1138.
[29] Naëgelé B, Thouvard V, Pépin J L, et al. Deficits of cognitive executive functions in patients with sleep apnea syndrome[J]. Sleep, 1995, 18(1):43-52.
[30] Verstraeten E, Cluydts R, Pevernagie D, et al. Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention[J]. Sleep, 2004, 27(4):685-693.
[31] Landes A M, Sperry S D, Strauss M E, et al. Apathy in Alzheimer's disease[J]. J Am Geriat Soc, 2001, 49(12):1700-1707.
[32] Rea R, Carotenuto A, Fasanaro A M, et al. Apathy in Alzheimer's disease: Any effective treatment?[J]. Scient World J, 2014, doi:10.1155/2014/421385.
[33] Hasin D, Hatzenbuehler M L, Keyes K, et al. Substance use disorders: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10)[J]. Addiction, 2006, 101(1):59-75.
[34] Thase M E. Antidepressant treatment of the depressed patient with insomnia[J]. J Clin Psychiatry, 1999, 60(17):28-31.
[35] Sutton E L. Psychiatric disorders and sleep issues[J]. Med Clin North Am, 2014, 98(5):1123-1143.
[36] Migliorelli R, Tesón A, Sabe L, et al. Prevalence and correlates of dysthymia and major depression among patients with Alzheimer's disease[J]. Am J Psychiatry, 1995, 152(1):37-44.
[37] Luca A, Luca M, Calandra C. Sleep disorders and depression: brief review of the literature, case report, and nonpharmacologic interventions for depression[J]. Clin Interv Aging, 2013, 8:1033-1042.
[38] Tagai K, Nagata T, Shinagawa S, et al. Correlation between both morphologic and functional changes and anxiety in alzheimer's disease[J]. Dement Geriatr Cogn Disord, 2014, 38(3-4):153-160.
[39] Potvin O, Lorrain D, Belleville G, et al. Subjective sleep characteristics associated with anxiety and depression in older adults: a population-based study[J]. Int J Geriatr Psychiatry, 2014, 29(12):1262-1270.
[40] Sharafkhaneh A, Giray N, Richardson P, et al. Association of psychiatric disorders and sleep apnea in a large cohort[J]. Sleep, 2005, 28(11):1405-1411.
[41] Gaugler J E, Kane R L, Kane R A, et al. Unmet care needs and key outcomes in dementia[J]. J Am Geriatr Soc, 2005, 53(12):2098-2105.
[42] Hope T, Keene J, Gedling K, et al. Predictors of institutionalization for people with dementia living at home with a carer[J]. Inter J Geriatr Psychiatry, 1998, 13(10):682-690.
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