Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia
Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia
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DOI：
10.1159/000434629
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发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Sorbi, Sandro
中科院分区：
文献类型：
--
作者：
Guarnieri, Biancamaria;Sorbi, Sandro
背景资料：睡眠障碍和睡眠-觉醒节律的神经调节的破坏似乎参与认知下降的细胞和分子机制。虽然睡眠问题在轻度认知障碍（MCI）和许多类型的痴呆症中非常普遍，但它们尚未在临床环境中进行系统研究，并且通常仅由睡眠专家根据个人要求进行研究。总结：本文综述了认知功能下降背景下的睡眠障碍，并概述了痴呆和MCI患者的临床诊断和管理这些疾病。关键信息：睡眠障碍在很大程度上被低估，并且在痴呆症患者的全球管理中没有得到足够的关注。睡眠障碍对认知功能下降的个体的认知和身体功能有显著影响，并可能与重要的心理困扰和抑郁症有关。它们与行为问题和认知障碍的严重程度呈正相关。临床意义：意大利痴呆症研究协会睡眠研究小组最近的建议可用作MCI和痴呆患者睡眠障碍的临床评估和管理指南。睡眠障碍应通过深入的睡眠史、体格检查、问卷调查和临床量表进行仔细调查，并应在直接护理者的支持下进行验证。对老年人的建议可以作为一个框架，指导痴呆和MCI患者睡眠障碍的诊断和治疗。管理策略应基于对同一患者存在的每种睡眠问题选择不同的治疗方法，同时避免治疗之间的不良相互作用。(C)2015 S. Karger AG，巴塞尔
Background: Sleep disturbances and disruption of the neural regulation of the sleep-wake rhythm appear to be involved in the cellular and molecular mechanisms of cognitive decline. Although sleep problems are highly prevalent in mild cognitive impairment (MCI) and many types of dementia, they have not been systematically investigated in the clinical setting and are often only investigated by sleep specialists upon individual request. Summary: This review discusses sleep disorders in the context of cognitive decline and provides an overview of the clinical diagnosis and management of these disorders in patients with dementia and MCI. Key Messages: Sleep disorders are largely underestimated and do not receive sufficient attention in the global management of dementia patients. Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression. They are positively associated with the severity of behavioral problems and cognitive impairment. Clinical Implications: The recent recommendations by the Sleep Study Group of the Italian Dementia Research Association can be used as a guideline for the clinical assessment and management of sleep disorders in MCI and dementia patients. Sleep disorders should be carefully investigated using an in-depth sleep history, physical examination, questionnaires and clinical scales and should be validated with the support of a direct caregiver. The recommendations for older adults can be used as a framework to guide the diagnosis and treatment of sleep disorders in individuals with dementia and MCI. The management strategy should be based on the choice of different treatments for each sleep problem present in the same patient, while avoiding adverse interactions between treatments. (C) 2015 S. Karger AG, Basel