Advertisement

The journal of nutrition, health & aging

, Volume 14, Issue 3, pp 212–217 | Cite as

Sleep disorders in aging and dementia

  • S. BomboisEmail author
  • P. Derambure
  • F. Pasquier
  • C. Monaca
Article

Abstract

This paper reviews the characteristics of sleep disorders found in people at a greater risk of dementia: the elderly adult, patients with mild cognitive impairment (MCI) and those with neurodegenerative diseases. The frequency of sleep architecture modifications and circadian rhythm sleep disturbances increases with age. Although around 40% of older adults complain of poor sleep, true sleep disorders are far less prevalent in healthy older adults and are frequently associated with comorbidities. The sleep disorders observed in Alzheimer’s disease (AD) patients are often similar to (but more intense than) those found in non-demented elderly people. Poor sleep results in an increased risk of significant morbidities and even mortality in demented patients and constitutes a major source of stress for caregivers. The prevalence of primary sleep disorders such as rapid eye movement (REM) sleep behavior disorders (RBDs), restless legs syndrome (RLS), periodic limb movements (PLMs) and sleep-disordered breathing increases with age. There are no published data on RLS and PLMs in demented persons but RBDs and sleep apnea syndrome have been studied more extensively. In fact, RBDs are suggestive of Lewy body dementia (LBD) and are predictive for neurodegeneration in Parkinson’s disease. Obstructive sleep apnea (OSA) shares common risk factors with AD and may even be an integral part of the pathological process in AD. In MCI patients, the hypotheses in which (i) sleep disorders may represent early predictive factors for progression to dementia and (ii) MCI is symptomatic of a non-diagnosed sleep disorder remain to be elucidated. Guidelines for drug and non-drug treatments of sleep disorders in the elderly and in demented patients are also considered in this review. In healthy but frail elderly people and in early-stage AD patients, sleep should be more thoroughly characterized (notably by using standardized interviews and polysomnographic recording).

Key words

Sleep aging dementia Alzheimer’s disease Lewy body dementia mild cognitive impairment 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Vitiello, M. V. & Borson, S. Sleep disturbances in patients with Alzheimer’s disease: epidemiology, pathophysiology and treatment. CNS Drugs 2001;15:777–796.CrossRefPubMedGoogle Scholar
  2. 2.
    Foley, D. J., Monjan, A. A., Brown, S. L., Simonsick, E. M., Wallace, R. B. & Blazer, D. G. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18:425–432.PubMedGoogle Scholar
  3. 3.
    Tractenberg, R. E., Singer, C. M., Cummings, J. L. & Thal, L. J. The Sleep Disorders Inventory: an instrument for studies of sleep disturbance in persons with Alzheimer’s disease. J Sleep Res 2003;12:331–337.PubMedGoogle Scholar
  4. 4.
    McCurry, S. M., Reynolds, C. F., Ancoli-Israel, S., Teri, L. & Vitiello, M. V. Treatment of sleep disturbance in Alzheimer’s disease. Sleep Med Rev 2000;4:603–628.CrossRefPubMedGoogle Scholar
  5. 5.
    Gaugler, J. E., Edwards, A. B., Femia, E. E., Zarit, S. H., Stephens, M. A., Townsend, A. & Greene, R. Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement. J Gerontol B Psychol Sci Soc Sci 2000;55:P247–255.PubMedGoogle Scholar
  6. 6.
    Benito-Leon, J., Bermejo-Pareja, F., Vega, S. & Louis, E. D. Total daily sleep duration and the risk of dementia: a prospective population-based study. Eur J Neurol 2009;16:990–997.CrossRefPubMedGoogle Scholar
  7. 7.
    Nieoullon, A., Bentue-Ferrer, D., Bordet, R., Tsolaki, M. & Forstl, H. Importance of circadian rhythmicity in the cholinergic treatment of Alzheimer’s disease: focus on galantamine*. Curr Med Res Opin 2008;24:3357–3367.CrossRefPubMedGoogle Scholar
  8. 8.
    Forbes, D., Culum, I., Lischka, A. R., Morgan, D. G., Peacock, S., Forbes, J. & Forbes, S. Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia. Cochrane Database Syst Rev 2009;CD003946.Google Scholar
  9. 9.
    Bloom HG, A. I., Alessi CA, Ancoli-Israel S, Buysse DJ, Kryger MH, Phillips BA, Thorpy MJ, Vitiello MV, Zee PC. Evidence-based recommandations for the assessment and management of sleep disorders in older persons. J Am Geriatr Soc 2009;57:761–789.CrossRefPubMedGoogle Scholar
  10. 10.
    Evans, L. K. Sundown syndrome in institutionalized elderly. J Am Geriatr Soc 1987;35:101–108.PubMedGoogle Scholar
  11. 11.
    Gallagher-Thompson, D., Brooks, J. O., 3rd, Bliwise, D., Leader, J. & Yesavage, J. A. The relations among caregiver stress, “sundowning” symptoms, and cognitive decline in Alzheimer’s disease. J Am Geriatr Soc 1992;40:807–810.PubMedGoogle Scholar
  12. 12.
    American Academy of Sleep Medicine. The international classification of sleep disorders. 2nd ed. Westchester, IL: American Academy of Sleep Medicine (2005).Google Scholar
  13. 13.
    Iranzo, A., Santamaria, J. & Tolosa, E. The clinical and pathophysiological relevance of REM sleep behavior disorder in neurodegenerative diseases. Sleep Med Rev. 2009;32(9):1149–53.Google Scholar
  14. 14.
    Boeve, B. F., Silber, M. H. & Ferman, T. J. REM sleep behavior disorder in Parkinson’s disease and dementia with Lewy bodies. J Geriatr Psychiatry Neurol 2004;17:146–157.CrossRefPubMedGoogle Scholar
  15. 15.
    Ferman, T. J., Smith, G. E., Boeve, B. F., Ivnik, R. J., Petersen, R. C., Knopman, D., Graff-Radford, N., Parisi, J. & Dickson, D. W. LBD fluctuations: specific features that reliably differentiate LBD from AD and normal aging. Neurology 2004;62:181–187.PubMedGoogle Scholar
  16. 16.
    McKeith, I. G., Dickson, D. W., Lowe, J., Emre, M., O’Brien, J. T., Feldman, H., Cummings, J., Duda, J. E., Lippa, C. et al. Diagnosis and management of dementia with Lewy bodies: third report of the LBD Consortium. Neurology 2005;65:1863–1872.CrossRefPubMedGoogle Scholar
  17. 17.
    Postuma, R. B., Gagnon, J. F., Vendette, M., Fantini, M. L., Massicotte-Marquez, J. & Montplaisir, J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology 2009;72:1296–1300.PubMedGoogle Scholar
  18. 18.
    Gagnon, J. F., Petit, D., Fantini, M. L., Rompre, S., Gauthier, S., Panisset, M., Robillard, A. & Montplaisir, J. REM sleep behavior disorder and REM sleep without atonia in probable Alzheimer disease. Sleep 2006;29:1321–1325.PubMedGoogle Scholar
  19. 19.
    The International Restless Legs Syndrome Study Group, Walters SA. Toward a better definition of the restless legs syndrome. Mov Disord 1995;10:634–642.CrossRefPubMedGoogle Scholar
  20. 20.
    Allen, R. P., Kushida, C. A. & Atkinson, M. J. Factor analysis of the International Restless Legs Syndrome Study Group’s scale for restless legs severity. Sleep Med 2003;4:133–135.CrossRefPubMedGoogle Scholar
  21. 21.
    Phillips, B., Young, T., Finn, L., Asher, K., Hening, W. A. & Purvis, C. Epidemiology of restless legs symptoms in adults. Arch Intern Med 2000;160:2137–2141.CrossRefPubMedGoogle Scholar
  22. 22.
    Tison, F., Crochard, A., Leger, D., Bouee, S., Lainey, E. & El Hasnaoui, A. Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology 2005;65:239–246.CrossRefPubMedGoogle Scholar
  23. 23.
    Pearson, V. E., Allen, R. P., Dean, T., Gamaldo, C. E., Lesage, S. R. & Earley, C. J. Cognitive deficits associated with restless legs syndrome (RLS). Sleep Med 2006;7:25–30.CrossRefPubMedGoogle Scholar
  24. 24.
    Ohayon, M. M. & Roth, T. (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53:547–554.CrossRefPubMedGoogle Scholar
  25. 25.
    Scofield, H., Roth, T. & Drake, C. Periodic limb movements during sleep: population prevalence, clinical correlates, and racial differences. Sleep 2008;31:1221–1227.PubMedGoogle Scholar
  26. 26.
    Ferri, R., Manconi, M., Lanuzza, B., Cosentino, F. I., Bruni, O., Ferini-Strambi, L. & Zucconi, M. Age-related changes in periodic leg movements during sleep in patients with restless legs syndrome. Sleep Med 2008;9:790–798.CrossRefPubMedGoogle Scholar
  27. 27.
    Richards, K. C., Roberson, P. K., Simpson, K., Lambert, C. W., Bliwise, D. L., Cole, C. S., Enderlin, C., Shue, V. M., Siddiqui, N. & Williams, J. S. Periodic leg movements predict total sleep time in persons with cognitive impairment and sleep disturbance. Sleep 2008;31:224–230.PubMedGoogle Scholar
  28. 28.
    Levy, P., Pepin, J. L., Malauzat, D., Emeriau, J. P. & Leger, J. M. Is sleep apnea syndrome in the elderly a specific entity? Sleep 1996;19:S29–38.PubMedGoogle Scholar
  29. 29.
    Ancoli-Israel, S., Kripke, D. F., Klauber, M. R., Mason, W. J., Fell, R. & Kaplan, O. Sleep-disordered breathing in community-dwelling elderly. Sleep 1991;14:486–495.PubMedGoogle Scholar
  30. 30.
    Pavlova, M. K., Duffy, J. F. & Shea, S. A. Polysomnographic respiratory abnormalities in asymptomatic individuals. Sleep 2008;31:241–248.PubMedGoogle Scholar
  31. 31.
    Ancoli-Israel, S., Klauber, M. R., Butters, N., Parker, L. & Kripke, D. F. Dementia in institutionalized elderly: relation to sleep apnea. J Am Geriatr Soc 1991;39:258–263.PubMedGoogle Scholar
  32. 32.
    Ancoli-Israel, S., Kripke, D. F., Klauber, M. R., Fell, R., Stepnowsky, C., Estline, E., Khazeni, N. & Chinn, A. Morbidity, mortality and sleep-disordered breathing in community dwelling elderly. Sleep 1996;19:277–282.PubMedGoogle Scholar
  33. 33.
    Kadotani, H., Kadotani, T., Young, T., Peppard, P. E., Finn, L., Colrain, I. M., Murphy, G. M., Jr. & Mignot, E. Association between apolipoprotein E epsilon4 and sleep-disordered breathing in adults. JAMA 2001;285:2888–2890.CrossRefPubMedGoogle Scholar
  34. 34.
    Gottlieb, D. J., DeStefano, A. L., Foley, D. J., Mignot, E., Redline, S., Givelber, R. J. & Young, T. APOE epsilon4 is associated with obstructive sleep apnea/hypopnea: the Sleep Heart Health Study. Neurology 2004;63:664–668.PubMedGoogle Scholar
  35. 35.
    Foley, D. J., Masaki, K., White, L. & Redline, S. Relationship between apolipoprotein E epsilon4 and sleep-disordered breathing at different ages. JAMA 2001;286:1447–1448.CrossRefPubMedGoogle Scholar
  36. 36.
    Sun, X., He, G., Qing, H., Zhou, W., Dobie, F., Cai, F., Staufenbiel, M., Huang, L. E. & Song, W. Hypoxia facilitates Alzheimer’s disease pathogenesis by up-regulating BACE1 gene expression. Proc Natl Acad Sci U S A 2006;103:18727–18732.CrossRefPubMedGoogle Scholar
  37. 37.
    Aloia, M. S., Arnedt, J. T., Davis, J. D., Riggs, R. L. & Byrd, D. Neuropsychological sequelae of obstructive sleep apnea-hypopnea syndrome: a critical review. J Int Neuropsychol Soc 2004;10:772–785.CrossRefPubMedGoogle Scholar
  38. 38.
    Ancoli-Israel, S., Palmer, B. W., Cooke, J. R., Corey-Bloom, J., Fiorentino, L., Natarajan, L., Liu, L., Ayalon, L., He, F. & Loredo, J. S. Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study. J Am Geriatr Soc 2008;56:2076–2081.CrossRefPubMedGoogle Scholar
  39. 39.
    Chong, M. S., Ayalon, L., Marler, M., Loredo, J. S., Corey-Bloom, J., Palmer, B. W., Liu, L. & Ancoli-Israel, S. Continuous positive airway pressure reduces subjective daytime sleepiness in patients with mild to moderate Alzheimer’s disease with sleep disordered breathing. J Am Geriatr Soc 2006;54:777–781.CrossRefPubMedGoogle Scholar
  40. 40.
    Bliwise, D. L. Is sleep apnea a cause of reversible dementia in old age? J Am Geriatr Soc 1996;44:1407–1409.PubMedGoogle Scholar
  41. 41.
    Moraes, W., Poyares, D., Sukys-Claudino, L., Guilleminault, C. & Tufik, S. Donepezil improves obstructive sleep apnea in Alzheimer disease: a double-blind, placebo-controlled study. Chest 2008;133:677–683.CrossRefPubMedGoogle Scholar
  42. 42.
    Petersen, R. C. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194.CrossRefPubMedGoogle Scholar
  43. 43.
    Beaulieu-Bonneau, S. & Hudon, C. Sleep disturbances in older adults with mild cognitive impairment. Int Psychogeriatr 2009;21:654–666.CrossRefPubMedGoogle Scholar
  44. 44.
    Geda, Y. E., Smith, G. E., Knopman, D. S., Boeve, B. F., Tangalos, E. G., Ivnik, R. J., Mrazek, D. A., Edland, S. D. & Petersen, R. C. De novo genesis of neuropsychiatric symptoms in mild cognitive impairment (MCI). Int Psychogeriatr 2004;16:51–60.CrossRefPubMedGoogle Scholar
  45. 45.
    Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. & DeKosky, S. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA 2002;288:1475–1483.CrossRefPubMedGoogle Scholar
  46. 46.
    Onor, M. L., Trevisiol, M., Negro, C. & Aguglia, E. Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer’s disease and their caregivers. Am J Alzheimers Dis Other Demen 2006;21:333–338.CrossRefPubMedGoogle Scholar
  47. 47.
    Lee, K. S., Cho, H. S., Hong, C. H., Kim, D. G. & Oh, B. H. Differences in neuropsychiatric symptoms according to mild cognitive impairment subtypes in the community. Dement Geriatr Cogn Disord 2008;26:212–217.CrossRefPubMedGoogle Scholar
  48. 48.
    Geda, Y. E., Roberts, R. O., Knopman, D. S., Petersen, R. C., Christianson, T. J., Pankratz, V. S., Smith, G. E., Boeve, B. F., Ivnik, R. J. et al. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study. Arch Gen Psychiatry 2008;65:1193–1198.CrossRefPubMedGoogle Scholar
  49. 49.
    Ellison, J. M. Mild cognitive impairment. CNS Spectr 2008;13:41–42.PubMedGoogle Scholar
  50. 50.
    Rozzini, L., Vicini Chilovi, B., Conti, M., Delrio, I., Borroni, B., Trabucchi, M. & Padovani, A. Neuropsychiatric symptoms in amnestic and nonamnestic mild cognitive impairment. Dement Geriatr Cogn Disord 2008;25:32–36.CrossRefPubMedGoogle Scholar
  51. 51.
    Gagnon, J. F., Vendette, M., Postuma, R. B., Desjardins, C., Massicotte-Marquez, J., Panisset, M. & Montplaisir, J. Mild cognitive impairment in rapid eye movement sleep behavior disorder and Parkinson’s disease. Ann Neurol 2009;66:39–47.CrossRefPubMedGoogle Scholar
  52. 52.
    Terzaghi, M., Sinforiani, E., Zucchella, C., Zambrelli, E., Pasotti, C., Rustioni, V. & Manni, R. Cognitive performance in REM sleep behaviour disorder: a possible early marker of neurodegenerative disease? Sleep Med 2008;9:343–351.CrossRefPubMedGoogle Scholar
  53. 53.
    Marques A, D. K., Boucart M, Pins D, Delliaux M, Defebvre L, Derambure P, Monaca C. REM sleep behaviour disorder and visuoperceptive dysfunction: a disorder of the ventral visual stream? J Neurol2009 Sep 30. [Epub ahead of print].Google Scholar

Copyright information

© Serdi and Springer Verlag France 2010

Authors and Affiliations

  • S. Bombois
    • 1
    • 2
    • 3
    Email author
  • P. Derambure
    • 1
    • 2
  • F. Pasquier
    • 1
    • 2
  • C. Monaca
    • 1
    • 2
  1. 1.Center for Memory Resources and Research, EA2691, Lille University HospitalUniversity of Lille Nord de France (Drs Bombois and Pasquier)Lille cedexFrance
  2. 2.Sleep Unit, Department of Clinical Neurophysiology, IFR 114, CNRS UMR 8160, Lille University HospitalUniversity of Lille Nord de France (Drs Derambure and Monaca)Lille cedexFrance
  3. 3.Memory ClinicSalengro HospitalLille cedexFrance

Personalised recommendations