Sleep disorders in people with dementia
Review of Karageorgiou E, Walsh C, Yaffe K et al (2017) Sleep disorders and dementia: from basic mechanisms to clinical decisions. Psychiatric Annals. 47, 5, 227-228.
Sleep disorders often precede cognitive impairment by many years. This is partly because some degenerative diseases originate in the hypothalamus and brain stem, which means fragmented sleep, daytime napping and sleep-phase disorders are early signs of these diseases. However, recent research indicates that amyloid proteins are removed from the brain during deep sleep so poor sleep can increase the amyloid plaques seen in Alzheimer’s disease. It is also known that sleep-disordered breathing can lead to periods of hypoxia, increasing vascular dementia.
As dementia progresses, production of the sleep-promoting hormone, melatonin, fluctuates across the day, leading to alternating sleep and wakefulness. Secretion of melatonin while a patient is still awake is a possible explanation for ‘sundowning’ with increased...
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