阿尔茨海默病患者睡眠障碍的研究新进展

doi:10.6040/j.issn.1673-3770.0.2014.235

摘要/Abstract

摘要： 睡眠障碍在阿尔茨海默病（AD）患者中发病率较高，最突出的表现为夜间觉醒的频率及持续时间增加，白天睡眠时间增加。多导睡眠监测（PSG）监测显示AD患者3期、4期及REM期睡眠减少，觉醒次数增多。AD患者睡眠障碍的类型主要有睡眠障碍性呼吸（SDB）、睡眠觉醒周期紊乱、不安腿综合征（RLS）、睡眠过度、日落综合征等。AD患者睡眠障碍的主要机制有：Aβ在脑内的沉积，视交叉上核、Meynert基底核等结构功能的退变。AD患者睡眠障碍主要与以下几个方面有关：男性、生理功能差、痴呆程度重、精神症状突出、应用较多催眠药物。尽管胆碱酯酶抑制剂、褪黑素、行为疗法、CPAP等有报道对AD患者的睡眠障碍有效，然而其有效性仍缺乏大规模的临床研究。睡眠障碍是AD患者常见的临床表现，这与相关脑区神经元的变性有关，并受诸多因素影响，而目前对于睡眠障碍尚无有效的治疗方法，因此仍需进一步的临床研究，为AD睡眠障碍的预防和治疗提供客观依据。回顾国内外关于阿尔茨海默病患者睡眠障碍的相关文献，并对其研究结果进行综述。

关键词: 阿尔茨海默病, 睡眠障碍, 睡眠障碍性呼吸, 影响因素, 睡眠觉醒周期紊乱

Abstract: The incidence of sleep disorder is high in patients with Alzheimer's disease. It is characterized by the increase of nocturnal awakenings and sleep time during the day. Polysomnography shows the stage 3, 4 and REM sleep time decrease and the number of WASO(wake after sleep onset) increases. The main types of sleep disorder in AD patients are sleep disordered breathing, sleep-wake cycle disorders, restless leg syndrome, hypersomnia and sundowning.The sleep disorders occur in AD patients via the following principal mechanisms: the deposition of Aβ in brain and the degeneration of suprachiasmatic nucleus and nucleus basalis of Meynert. The sleep disorders are mainly related to the following aspects: gender, physiological function, degree of dementia, psychiatric syndromes and the use of hyptonic agents. Cholinesterase inhibitors, melatonin, behavior therapy, continuos positive airway pressure have been reported effective against sleep disorders, while they need to be proven in larger clinical studies. Sleep disorder is a common manifestation in AD patients, generated by brain neuronal degenerations, and are affected by many factors. However, there is little confirmed effective therapy for sleep disorder.Therefor,further researches are needed for its prevention and treatment.Relevant literatures about sleep disorder in AD patients at home and abroad are reviewed in this paper.

Key words: Sleep disorder, Sleep-wake cycle disorders, Affective factor, Sleep disordered breathing, Alzheimer’s disease

中图分类号:

R741

何迎雪, 丛琳, 杜怡峰. 阿尔茨海默病患者睡眠障碍的研究新进展[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 1-5.

HE Ying-xue, CONG Lin, DU Yi-feng. New advance in sleep disorders of Alzheimer’s disease[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(4): 1-5.

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