title: Elevation of serum TNF-α levels in mild and moderate Alzheimer patients with daytime sleepiness.
abstract: OBJECTIVE
  Sleep disturbance has been noted to accompany Alzheimer disease and is more pronounced as dementia severity increases. The aim of this study was to examine whether sleep disturbance in a cohort of patients with mild/moderate AD was associated with serum levels of IL-1β and TNF-α.
  
  
  METHODS
  Forty three drug-free AD patients and twenty two healthy controls were evaluated. All subjects underwent two consecutive full-night polysomnography. Their daytime sleepiness was assessed by Epworth Sleepiness Scale (ESS). Serum levels of IL-1β and TNF-α were measured by enzyme linked immunoassays.
  
  
  RESULTS
  AD patients showed lower sleep efficiency, more awakenings and less slow wave sleep (SWS). IL-1β was detectable only in two AD patients. Serum TNF-α concentrations did not differ significantly between AD patients and controls. When AD patients were classified as AD patients with daytime sleepiness (n=20, ESS>10) or AD patients without daytime sleepiness (n=23, ESS<10) according to their ESS scores, serum levels of TNF-α was significantly higher in AD patients with daytime sleepiness than that in those without daytime sleepiness or controls (32.7±17.9 vs 5.2±2.4, p<0.05; 40.9±22.3 vs 5.7±2.2, p<0.05). Serum level of TNF-α was significantly correlated with ESS score.
  
  
  CONCLUSIONS
  These data indicate that daytime sleepiness in mild and moderate AD patients is associated with elevation of serum TNF-α concentrations.
authors.affiliation: Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.forename: You
authors.initials: Y
authors.lastname: Yin
authors.forename: Zhongxin
authors.initials: Z
authors.lastname: Zhao
authors.forename: Liuqing
authors.initials: L
authors.lastname: Huang
authors.forename: Shuqi
authors.initials: S
authors.lastname: Huang
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhuang
authors.forename: Huijuan
authors.initials: H
authors.lastname: Wu
authors.forename: Hua
authors.initials: H
authors.lastname: Peng
authors.forename: Peng
authors.initials: P
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D014409:Tumor Necrosis Factor-alpha