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Mayer G, Frohnhofen H, Jokisch M, Hermann DM, Gronewold J. Associations of sleep disorders with all-cause MCI/dementia and different types of dementia - clinical evidence, potential pathomechanisms and treatment options: A narrative review. Front Neurosci 2024; 18:1372326. [PMID: 38586191 PMCID: PMC10995403 DOI: 10.3389/fnins.2024.1372326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Due to worldwide demographic change, the number of older persons in the population is increasing. Aging is accompanied by changes of sleep structure, deposition of beta-amyloid (Aß) and tau proteins and vascular changes and can turn into mild cognitive impairment (MCI) as well as dementia. Sleep disorders are discussed both as a risk factor for and as a consequence of MCI/dementia. Cross-sectional and longitudinal population-based as well as case-control studies revealed sleep disorders, especially sleep-disorderded breathing (SDB) and excessive or insufficient sleep durations, as risk factors for all-cause MCI/dementia. Regarding different dementia types, SDB was especially associated with vascular dementia while insomnia/insufficient sleep was related to an increased risk of Alzheimer's disease (AD). Scarce and still inconsistent evidence suggests that therapy of sleep disorders, especially continuous positive airway pressure (CPAP) in SDB, can improve cognition in patients with sleep disorders with and without comorbid dementia and delay onset of MCI/dementia in patients with sleep disorders without previous cognitive impairment. Regarding potential pathomechanisms via which sleep disorders lead to MCI/dementia, disturbed sleep, chronic sleep deficit and SDB can impair glymphatic clearance of beta-amyloid (Aß) and tau which lead to amyloid deposition and tau aggregation resulting in changes of brain structures responsible for cognition. Orexins are discussed to modulate sleep and Aß pathology. Their diurnal fluctuation is suppressed by sleep fragmentation and the expression suppressed at the point of hippocampal atrophy, contributing to the progression of dementia. Additionally, sleep disorders can lead to an increased vascular risk profile and vascular changes such as inflammation, endothelial dysfunction and atherosclerosis which can foster neurodegenerative pathology. There is ample evidence indicating that changes of sleep structure in aging persons can lead to dementia and also evidence that therapy of sleep disorder can improve cognition. Therefore, sleep disorders should be identified and treated early.
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Affiliation(s)
- Geert Mayer
- Department of Neurology, Philipps-Universität Marburg, Marburg, Germany
| | - Helmut Frohnhofen
- Department of Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
- Department of Medicine, Geriatrics, Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Martha Jokisch
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Dirk M. Hermann
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Janine Gronewold
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Wennberg A, Lenzoni S, Turcano P, Casagrande E, Caumo L, Sorarú G, Pegoraro E, Semenza C. Subjective Sleep Quality as it Relates to Cognitive and Physical Function in Spinal Muscular Atrophy Patients. J Neuromuscul Dis 2023:JND221627. [PMID: 37182894 DOI: 10.3233/jnd-221627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Sleep quality and its association with cognition has been widely studied in some neurodegenerative diseases, but less is known about this association in spinal muscular atrophy (SMA). In adult SMA (n = 21) patients and age-matched controls (n = 23), we assessed subjectively measured sleep quality and daytime somnolence. Cognition was assessed with a multi-domain neuropsychological battery. Further, we investigated the association between clinical functional scores and sleep questionnaire scores. Among SMA patients, better motor and limb function was associated with better subjective sleep quality (p's< 0.05). Clinicians should consider sleep quality in patient care and future studies are needed to better understand these relationships.
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Affiliation(s)
- Alexandra Wennberg
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
| | - Sabrina Lenzoni
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
| | | | - Elena Casagrande
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
| | - Luca Caumo
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
- ERN Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
| | - Gianni Sorarú
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
- ERN Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
| | - Elena Pegoraro
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
- ERN Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
| | - Carlo Semenza
- Department of Neurosciences (Padova NeuroscienceCenter), Universitá degli Studi di Padova, Italy
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Mutti C, Angeli MC, Rausa F, Tontini V, Pizzarotti S, Soglia M, Pollara I, Rapina C, Azzi N, Zinno L, Parrino L. Sleep macro- and micro-structure in autoimmune encephalitis: single case report from the subacute phase of the disease to the follow-up. Neurocase 2022; 28:235-238. [PMID: 35531934 DOI: 10.1080/13554794.2022.2072228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Sleep disorders are frequently described in autoimmune encephalitis (AE); however, data on sleep texture are fragmentary. We analyzed the polysomnography of a woman affected by AE, and we performed cyclic alternating pattern (CAP) scoring during the subacute phase of the disease and at follow-up. The first polysomnography showed deviations both at macro and microstructure levels, with a marked reduction of CAP rate compare to healthy sleepers (20.8% vs 33%). After 6-months sleep macrostructure improved, whilst CAP parameters remained abnormal. This is the first polysomnographic analysis, comprehensive of microstructural data, performed in AE. We briefly discuss the results.
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Affiliation(s)
- Carlotta Mutti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Marco Cesare Angeli
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Francesco Rausa
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Valentina Tontini
- Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Silvia Pizzarotti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Margherita Soglia
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Irene Pollara
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Clara Rapina
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Nicoletta Azzi
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Lucia Zinno
- Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Liborio Parrino
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy
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