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Sleep in older adults and in subjects with dementia

Schlaf bei älteren Erwachsenen und Patienten mit Demenz

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Abstract

The neuronal structures for the regulation of sleep and wakefulness are located in the brain. This complex network is vulnerable to numerous factors, most importantly neurodegenerative diseases and drugs. The macrostructure and microstructure of sleep change with age. These changes are more pronounced in subjects with dementia. Sleep disorders in subjects with dementia may be independent of dementia or caused by dementia. Furthermore, epidemiological studies reveal that sleep disorders per se may induce dementia by reduction of cerebral clearance of beta-amyloids. The population attributable risk (PAR) of sleep disturbances to the incidence of dementia is estimated to be about 15%; therefore, management of sleep disturbances in older adults and subjects with dementia gives the opportunity of an impact on incidence and course of dementia. Sleep history should be taken from each individual and obvious sleep disturbances, especially sleep apnea, should be managed according to current guidelines. Future studies that concern the incidence and the management of dementia must take into account sleep and sleep disturbances.

Zusammenfassung

Die neuronalen Strukturen für die Regulierung von Schlaf und Wachheit befinden sich im Gehirn. Dieses komplexe Netzwerk ist anfällig für zahlreiche Einflüsse wie neurodegenerative Erkrankungen oder Medikamente. Die Makro- und Mikrostruktur des Schlafes ändern sich mit dem Alter. Diese Veränderungen sind bei Probanden mit Demenz erheblich stärker ausgeprägt. Schlafstörungen bei Demenzkranken können unabhängig von oder auch Folge der Demenzerkrankung sein. Darüber hinaus zeigen epidemiologische Untersuchungen, dass Schlafstörungen durch eine Reduktion der zerebralen Clearance von β‑Amyloiden eine Demenz hervorrufen können. Das den Schlafstörungen zuzuweisende Risiko (PAR) für die Inzidenz einer Demenz wird auf etwa 15 % geschätzt. Daher bietet das Management von Schlafstörungen die Möglichkeit, Einfluss zu nehmen auf die Inzidenz und den Verlauf einer Demenz. Die Schlafanamnese sollte bei jedem Patienten erfragt werden. Zudem sollten offensichtliche Schlafstörungen – insbesondere eine Schlafapnoe – entsprechend behandelt werden. Zukünftige Studien im Bereich der Demenzforschung müssen Schlaf- und Schlafstörungen berücksichtigen

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Authors and Affiliations

  1. Faculty of Health, University Witten-Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany

    Helmut Frohnhofen

  2. Klniken Essen Mitte, Am Deimelsberg 34a, 45276, Essen, Germany

    Jeanina Schlitzer

  3. Klinik Ghersburg, 83043, Bad Aibling, Germany

    Nikolaus Netzer

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  1. Helmut Frohnhofen
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  2. Jeanina Schlitzer
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Correspondence to Helmut Frohnhofen.

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H. Frohnhofen, J. Schlitzer and N. Netzer declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Frohnhofen, H., Schlitzer, J. & Netzer, N. Sleep in older adults and in subjects with dementia. Z Gerontol Geriat 50, 603–608 (2017). https://doi.org/10.1007/s00391-017-1289-0

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