Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging

Annachiara Cagnin, Federica Fragiacomo, Giulia Camporese, Matteo Turco, Cinzia Bussè, Mario Ermani, Sara Montagnese

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. Objectives: To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. Methods: 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders. A comprehensive sleep-wake profile was obtained including a set of questionnaires [Pittsburgh Sleep Quality Index (PSQI), REM Sleep Behavior Disorder Single-Question screen (RBD1Q), Epworth Sleepiness Scale (ESS)] and 12-day sleep diaries. Results: Patients were matched for age, gender, and disease severity. DLB patients showed more severe daytime somnolence/dysfunction due to somnolence, and a higher proportion of RBD-like symptoms (70) compared to AD and controls (p < 0.001), regardless of the presence of psychoactive drug treatment. As for sleep timing, DLB patients had a greater number of daytime naps and longer night sleep, with the latter being associated with use of clonazepam. The severity of fluctuations was associated with the presence of RBD (Clinician Assessment of Fluctuation score = RBD: 5.2±3.7; RBD-: 2.1±3.2, p = 0.04). AD patients reported the best sleep-wake profile, while healthy controls declared the poorest sleep quality, although sleep timing and the quality of wakefulness were comparable between AD and controls. Discussion: RBD and daytime fluctuations of attention may coexist in DLB and even reciprocally potentiate each other. Self-reports of sleep quality may lead to an underestimation of sleep disturbances in AD, possibly influenced by anosognosia, compared to normal elderly individuals who complain mainly of insomnia.

Original languageEnglish
Pages (from-to)1529-1536
Number of pages8
JournalJournal of Alzheimer's Disease
Volume55
Issue number4
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Lewy Body Disease
Dementia
Alzheimer Disease
Sleep
REM Sleep Behavior Disorder
Agnosia
Clonazepam
Wakefulness
Psychotropic Drugs
Sleep Initiation and Maintenance Disorders
Self Report
Healthy Volunteers

Keywords

  • Alzheimer's disease
  • dementia with Lewy bodies
  • REM sleep behavior disorder
  • sleep disturbances

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Cagnin, A., Fragiacomo, F., Camporese, G., Turco, M., Bussè, C., Ermani, M., & Montagnese, S. (2017). Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging. Journal of Alzheimer's Disease, 55(4), 1529-1536. https://doi.org/10.3233/JAD-160385

Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging. / Cagnin, Annachiara; Fragiacomo, Federica; Camporese, Giulia; Turco, Matteo; Bussè, Cinzia; Ermani, Mario; Montagnese, Sara.

In: Journal of Alzheimer's Disease, Vol. 55, No. 4, 01.01.2017, p. 1529-1536.

Research output: Contribution to journalArticle

Cagnin, A, Fragiacomo, F, Camporese, G, Turco, M, Bussè, C, Ermani, M & Montagnese, S 2017, 'Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging', Journal of Alzheimer's Disease, vol. 55, no. 4, pp. 1529-1536. https://doi.org/10.3233/JAD-160385
Cagnin A, Fragiacomo F, Camporese G, Turco M, Bussè C, Ermani M et al. Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging. Journal of Alzheimer's Disease. 2017 Jan 1;55(4):1529-1536. https://doi.org/10.3233/JAD-160385
Cagnin, Annachiara ; Fragiacomo, Federica ; Camporese, Giulia ; Turco, Matteo ; Bussè, Cinzia ; Ermani, Mario ; Montagnese, Sara. / Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging. In: Journal of Alzheimer's Disease. 2017 ; Vol. 55, No. 4. pp. 1529-1536.
@article{5c09a696da10430389e4b809ae3a3519,
title = "Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging",
abstract = "Background: Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. Objectives: To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. Methods: 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders. A comprehensive sleep-wake profile was obtained including a set of questionnaires [Pittsburgh Sleep Quality Index (PSQI), REM Sleep Behavior Disorder Single-Question screen (RBD1Q), Epworth Sleepiness Scale (ESS)] and 12-day sleep diaries. Results: Patients were matched for age, gender, and disease severity. DLB patients showed more severe daytime somnolence/dysfunction due to somnolence, and a higher proportion of RBD-like symptoms (70) compared to AD and controls (p < 0.001), regardless of the presence of psychoactive drug treatment. As for sleep timing, DLB patients had a greater number of daytime naps and longer night sleep, with the latter being associated with use of clonazepam. The severity of fluctuations was associated with the presence of RBD (Clinician Assessment of Fluctuation score = RBD: 5.2±3.7; RBD-: 2.1±3.2, p = 0.04). AD patients reported the best sleep-wake profile, while healthy controls declared the poorest sleep quality, although sleep timing and the quality of wakefulness were comparable between AD and controls. Discussion: RBD and daytime fluctuations of attention may coexist in DLB and even reciprocally potentiate each other. Self-reports of sleep quality may lead to an underestimation of sleep disturbances in AD, possibly influenced by anosognosia, compared to normal elderly individuals who complain mainly of insomnia.",
keywords = "Alzheimer's disease, dementia with Lewy bodies, REM sleep behavior disorder, sleep disturbances",
author = "Annachiara Cagnin and Federica Fragiacomo and Giulia Camporese and Matteo Turco and Cinzia Buss{\`e} and Mario Ermani and Sara Montagnese",
year = "2017",
month = "1",
day = "1",
doi = "10.3233/JAD-160385",
language = "English",
volume = "55",
pages = "1529--1536",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",
number = "4",

}

TY - JOUR

T1 - Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging

AU - Cagnin, Annachiara

AU - Fragiacomo, Federica

AU - Camporese, Giulia

AU - Turco, Matteo

AU - Bussè, Cinzia

AU - Ermani, Mario

AU - Montagnese, Sara

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. Objectives: To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. Methods: 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders. A comprehensive sleep-wake profile was obtained including a set of questionnaires [Pittsburgh Sleep Quality Index (PSQI), REM Sleep Behavior Disorder Single-Question screen (RBD1Q), Epworth Sleepiness Scale (ESS)] and 12-day sleep diaries. Results: Patients were matched for age, gender, and disease severity. DLB patients showed more severe daytime somnolence/dysfunction due to somnolence, and a higher proportion of RBD-like symptoms (70) compared to AD and controls (p < 0.001), regardless of the presence of psychoactive drug treatment. As for sleep timing, DLB patients had a greater number of daytime naps and longer night sleep, with the latter being associated with use of clonazepam. The severity of fluctuations was associated with the presence of RBD (Clinician Assessment of Fluctuation score = RBD: 5.2±3.7; RBD-: 2.1±3.2, p = 0.04). AD patients reported the best sleep-wake profile, while healthy controls declared the poorest sleep quality, although sleep timing and the quality of wakefulness were comparable between AD and controls. Discussion: RBD and daytime fluctuations of attention may coexist in DLB and even reciprocally potentiate each other. Self-reports of sleep quality may lead to an underestimation of sleep disturbances in AD, possibly influenced by anosognosia, compared to normal elderly individuals who complain mainly of insomnia.

AB - Background: Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. Objectives: To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. Methods: 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders. A comprehensive sleep-wake profile was obtained including a set of questionnaires [Pittsburgh Sleep Quality Index (PSQI), REM Sleep Behavior Disorder Single-Question screen (RBD1Q), Epworth Sleepiness Scale (ESS)] and 12-day sleep diaries. Results: Patients were matched for age, gender, and disease severity. DLB patients showed more severe daytime somnolence/dysfunction due to somnolence, and a higher proportion of RBD-like symptoms (70) compared to AD and controls (p < 0.001), regardless of the presence of psychoactive drug treatment. As for sleep timing, DLB patients had a greater number of daytime naps and longer night sleep, with the latter being associated with use of clonazepam. The severity of fluctuations was associated with the presence of RBD (Clinician Assessment of Fluctuation score = RBD: 5.2±3.7; RBD-: 2.1±3.2, p = 0.04). AD patients reported the best sleep-wake profile, while healthy controls declared the poorest sleep quality, although sleep timing and the quality of wakefulness were comparable between AD and controls. Discussion: RBD and daytime fluctuations of attention may coexist in DLB and even reciprocally potentiate each other. Self-reports of sleep quality may lead to an underestimation of sleep disturbances in AD, possibly influenced by anosognosia, compared to normal elderly individuals who complain mainly of insomnia.

KW - Alzheimer's disease

KW - dementia with Lewy bodies

KW - REM sleep behavior disorder

KW - sleep disturbances

UR - http://www.scopus.com/inward/record.url?scp=85007164339&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007164339&partnerID=8YFLogxK

U2 - 10.3233/JAD-160385

DO - 10.3233/JAD-160385

M3 - Article

AN - SCOPUS:85007164339

VL - 55

SP - 1529

EP - 1536

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

SN - 1387-2877

IS - 4

ER -