SLEEP DISTURBANCES IN NEURODEGENERATIVE DISORDERS.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 4083-4098
Abstract
Neurodegenerative disorders are those affecting the cognition, behavior and motor function of an individual. According to a report from the World Health Organization, an astounding 30 million people in Europe and United States alone will suffer with Alzheimer’s disease- one of the most common neurodegenerative disorders. Though many authors have extensively studied the pathophysiological mechanisms involved in these diseases, reporting neuroinflammation to be the cause with almost certainty; very few have tried to delineate the risk factors responsible for these diseases. Recent advances in polysomnography have indicated that patients with dementia displayed “increased wakefulness” after onset of sleep. Moreover, this increased wakefulness was directly related to the severity of the neurodegenerative disease. Subsequently, there is sleep fragmentation, excessive sleepiness during the day, and Rapid eye movement behavioral disorders in these patients. Motor disorders like the Parkinson’s disease are also associated with melatonin changes, thereby disrupting the whole sleep-wake pattern. Actigraphy studies have demonstrated that the risk of developing Alzheimer’s disease was 1.5 times higher in people with excessive sleep fragmentation. Apart from neuronal loss in the intermediate nucleus which maintains sleep, there is also a loss of orexin secreting neurons. Orexin is one of the neuropeptide involved in stabilizing the sleep-wake transitions. Several studies conducted in patients with Alzheimer’s disease using positron emission tomography have demonstrated that, accumulation of Amyloid Beta protein in brain was directly linked with poor sleep quality. Other studies on subjects with Parkinson’s have also linked the severity of motor manifestations with insomnia. Sleep disruption in neurodegenerative diseases is the major cause of institutionalization of the patients and is also a reason for caregiver distress.
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