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Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review

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Abstract

Clinical assessment and management of sleep disturbances in patients with mild cognitive impairment and dementia has important clinical and social implications. Poor sleep results in an increased risk of morbidities and mortality in demented patients and is a source of stress for caregivers. Sleep disturbances show high prevalence in mild cognitive impairment and dementia patients and they are often associated one to another in the same patient. A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of individuals with cognitive decline. The Sleep Study Group of the Italian Dementia Research Association (SINDem) reviewed evidence from original research articles, meta-analyses and systematic reviews published up to December 2013. The evidence was classified in quality levels (I, II, III) and strength of recommendations (A, B, C, D, E). Where there was a lack of evidence, but clear consensus, good practice points were provided. These recommendations may not be appropriate for all circumstances and should therefore be adopted only after a patient’s individual characteristics have been carefully evaluated.

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Abbreviations

ACT:

Actigraphy

AD:

Alzheimer’s disease

ASPD:

Advanced sleep phase disorder

BDI-II:

Beck depression inventory-II

BPSD:

Behavioral and psychological symptoms of dementia

BzRAs:

Benzodiazepine receptor agonists

CBD:

Corticobasal degeneration

CBT:

Cognitive behavioral therapy

CD:

Clinically definite

CP:

Clinically probable

CPAP:

Continuous positive airway pressure

CRSD:

Circadian sleep–wake rhythm disturbances

EDS:

Excessive daytime sleepiness

EEG:

Electroencephalographic

ESS:

Epworth sleepiness scale

FTD:

Frontotemporal dementia

ICD:

Impulse control disorder

IRLSSG:

International restless legs study group

LBD:

Lewy body dementia

LH:

Lateral hypothalamus

MCH:

Melanin-concentrating hormone

MCI:

Mild cognitive impairment

MCTQ:

Munich chronotype questionnaire

MEQ:

Morningness eveningness questionnaire

MSA:

Multiple system atrophy

MSLT:

Multiple sleep latency test

MSQ:

Mayo sleep questionnaire

MWT:

Maintenance of wakefulness test

OSAS:

Obstructive sleep apnea syndrome

PDD:

Parkinson’s disease dementia

PFA:

Perifornical area

PLM:

Periodic limb movements

PSG:

Polysomnography

PSP:

Progressive sopranuclear palsy

PSQI:

Pittsburgh sleep quality index

RBD:

REM behavior disorder

RLS:

Restless legs syndrome

SCN:

Suprachiasmatic nucleus

SDB:

Sleep-disordered breathing

SSRIs:

Selective serotonin reuptake inhibitors

VaD:

Vascular dementia

WED:

Willis Ekbom disease

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Acknowledgments

The authors wish to thank the Italian Association of Sleep Medicine (AIMS) Committee on neurodegenerative disorders for the important contribution given to this work.

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Guarnieri, B., Musicco, M., Caffarra, P. et al. Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review. Neurol Sci 35, 1329–1348 (2014). https://doi.org/10.1007/s10072-014-1873-7

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