Daytime sleepiness and functional impairment in Alzheimer disease
Daytime sleepiness and functional impairment in Alzheimer disease
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DOI：
10.1097/jgp.0b013e3180381521
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发表时间：
2007-07-01
影响因子：
7.2
通讯作者：
Levey, Allan I.
中科院分区：
文献类型：
--
作者：
Lee, Jung Hie;Bliwise, Donald L.;Levey, Allan I.
目的：白天睡眠已被注意到伴随痴呆症，并随着痴呆症的严重程度增加而更加明显。虽然被护理人员承认，但白天的嗜睡是阿尔茨海默病（AD）患者中描述的最不麻烦的睡眠行为之一。本研究的目的是检查AD患者和配偶/护理者报告的日间嗜睡是否与这些患者的功能状态降低相关。研究方法：作者使用埃普沃思嗜睡量表评估报告的日间嗜睡，并修改劳顿和布罗迪量表评估一组137例AD患者的功能状态。作者还通过问卷调查了典型的就寝时间和起床时间。结果：白天嗜睡程度越高，功能状态的损害越大。这些结果独立于认知障碍的水平，如简易精神状态检查所评估的，当作者将分析限制在仅由配偶/照顾者报告的数据时，它们也是可检测的。结果与药物使用无关。与对照组相比，AD患者的就寝时间更早，醒来时间更晚。结论：除了与认知功能受损有关外，白天嗜睡与AD患者的功能障碍有关。虽然白天睡眠可能是一个受欢迎的救济照顾者，它的存在可能与更大的损害，工具性活动，并可能需要干预。
Objective: Daytime sleep has been noted to accompany dementing illness and is more pronounced as dementia severity increases. Although acknowledged by caregivers, sleepiness during the daytime is among the least troublesome of sleep behaviors described in Alzheimer Disease ( AD) patients. The purpose of this study was to examine whether patient and spouse/caregiver reports of daytime sleepiness in AD were associated with lower functional status in those patients. Methods: The authors utilized the Epworth Sleepiness Scale to assess reported daytime sleepiness and a modification of the Lawton and Brody scale to assess functional status in a group of 137 AD patients. The authors also examined typical bedtimes and wakeup times via questionnaire. Results: Higher levels of daytime sleepiness were associated with greater impairments in functional status. These results were independent of level of cognitive impairment, as assessed with Mini-Mental State Exam, and they were also detectable when the authors limited analyses to data reported only by spouse/caregiver. Findings were not associated with medication use. AD patients also had earlier bedtimes and later wake-up times than a comparison group. Conclusion: Even apart from its association with impaired cognition, daytime sleepiness was associated with functional impairment in AD patients. Although daytime sleep may represent a welcome relief for caregivers, its presence may be associated with greater impairment in instrumental activities and may warrant intervention.