Home Sleep Therapy System for Mild Cognitive Impairment

一些研究结果表明，随着年龄的增长，深度睡眠（N3期）的不足会损害睡眠质量。 持续的记忆巩固可能导致轻度认知障碍的记忆衰退 损害（MCI）。此外，受损的N3睡眠也会导致β-肾上腺素分泌不足。 淀粉样蛋白和tau蛋白，多年的睡眠不佳可能会导致长期 导致阿尔茨海默病（AD）的神经变性。迄今为止的证据表明， 恶性循环：神经毒素的积累损害了深度睡眠的慢波阶段， 睡眠不足的程度似乎可以预测神经毒素的积累，从而发展为AD [1]的文件。本项目将创建Neurosom®电睡眠治疗（NEST）系统， 允许研究人员进行TES研究，以改善家中MCI老年人的睡眠 设置.该系统包括一个简单的电池供电的蓝牙头带， 脑电图（EEG）和经颅电刺激（TES），与 强大的床边纳米计算机，用于睡眠EEG分析和机器学习分类， 睡眠阶段与云服务的通信提供了对数据分析、内存 评估，并向患者和医生报告。通过实施和测试NEST 该项目将提供具有成本效益的监测工具， 生理和行为测量家中的睡眠质量。此外，它还将使研究人员 开发TES协议来操纵睡眠神经生理学，例如同步睡眠 纺锤波和N3睡眠的缓慢振荡。虽然我们的重点是 TES延长N3睡眠，EEG头带评估也将提供明确的睡眠 质量结果的措施，以评估各种方法的睡眠治疗老年MCI， 包括：睡眠卫生，改善运动，认知行为疗法，以及新的 药物制剂。这个项目的现实目标是提高睡眠质量， 老年MCI患者的记忆功能。如果证明改善睡眠是可行的， 更雄心勃勃的目标可能是延迟甚至避免数百万人患痴呆症 健康的老年人。为了提供这一长期目标的初步数据，第二阶段试验将 包括β淀粉样蛋白排泄（AB 40，AB 42）的系列血浆测量，以检验假设 改善深度睡眠可以改善有毒代谢物的胶质淋巴清除。

Several findings suggest that a deficit in deep sleep (stage N3) with increased age impairs ongoing memory consolidation possibly contributing to the memory decline of mild cognitive impairment (MCI). Furthermore, impaired N3 sleep also causes inadequate excretion of beta amyloids and tau protein, which over many years of poor sleep may contribute to the long term neural degeneration leading to Alzheimer's Disease (AD). The evidence to date implies a vicious circle: the buildup of neurotoxins impairs the slow wave stage of deep sleep, and the degree of sleep deficit appears to predict the buildup of neurotoxins and thus progression to AD [1]. The present project will create the Neurosom® Electric Sleep Therapy (NEST) system to allow researchers to conduct TES studies to improve sleep in seniors with MCI in their home setting. The system includes a simple battery-operated bluetooth headband for electroencephalography (EEG) and transcranial electrical stimulation (TES), linked with a powerful bedside nanocomputer for sleep EEG analysis and machine learning classification of sleep stages. Communication with cloud services provides support for data analysis, memory assessment, and reporting to the patient and physician. By implementing and testing the NEST system in the home environment, this project will provide cost-effective tools for monitoring physiologic and behavioral measures sleep quality at home. In addition, it will allow researchers to develop TES protocols for manipulating sleep neurophysiology, such as synchronizing sleep spindles and the slow oscillations of N3 sleep in at-risk populations. Although our focus is on TES to extend N3 sleep, the EEG headband assessment will also provide definitive sleep quality outcome measures to evaluate various approaches to sleep therapy in seniors with MCI, including: sleep hygiene, improved exercise, Cognitive Behavior Therapy for Insomnia, and new pharmacologic agents. The realistic goal from this project is improve the quality of sleep and memory function in older persons with MCI. If it proves feasible to improve sleep over many years, the more ambitious goal could be to delay or even avoid the onset of dementia in millions of healthy seniors. To provide preliminary data on this long-range goal, the Phase II trial will include serial plasma measures of beta amyloid excretion (AB40, AB42) to test the hypothesis that improved deep sleep may improve glymphatic clearance of toxic metabolites.