Current management of sleep disturbances in dementia.
Current management of sleep disturbances in dementia.
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DOI：
10.1007/s11910-002-0027-0
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发表时间：
2002-03-01
影响因子：
5.6
通讯作者：
Ferman, Tanis J
中科院分区：
文献类型：
--
作者：
Boeve, Bradley F;Silber, Michael H;Ferman, Tanis J
痴呆患者睡眠障碍的管理是一个复杂且非常重要的临床和社会问题。在这篇综述中，我们提出了一种诊断和管理这种睡眠障碍的方法。大多数的精神障碍可以分为四种主要症状：失眠、嗜睡、过度的夜间运动活动、幻觉或行为问题。我们描述了每种症状如何与痴呆症本身相关，哪些原发性睡眠障碍可能起作用，哪些用于痴呆症的药物可能影响症状，抑郁症在该症状中的作用，以及昼夜节律紊乱如何成为该症状的基础。虽然很少有精心设计的研究已经进行，我们目前的管理策略的基础上，文献和我们的临床经验的睡眠障碍。考虑到对患者和照顾者生活质量的影响，以及通过适当治疗延迟住院的可能性，显然有必要进一步研究以优化认知受损老年人群中睡眠障碍的诊断和管理。
The management of sleep disturbances in patients with dementia is a complicated and enormously important clinical and societal problem. In this review, we present one approach to the diagnosis and management of such sleep disturbances. Most disturbances can be categorized into four primary symptoms: insomnia, hypersomnia, excessive nocturnal motor activity, and hallucinations or behavioral problems. We describe how each symptom may relate to the dementing illnesses themselves, which primary sleep disorders may be at play, which medications employed for dementia may impact on the symptom, the role of depression in that symptom, and how circadian dysrhythmias can underlie that symptom. Although few well-designed studies have been conducted, we present management strategies for several sleep disturbances based on the literature and our clinical experience. Considering the impact on patient and caregiver quality of life, and the potential for delaying institutionalization with appropriate therapy, further research is clearly warranted to optimize the diagnosis and management of sleep disturbances in the cognitively impaired elderly population.