title: Sleep, Cognition and Dementia.
abstract: The older patient population is growing rapidly around the world and in the USA. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation all of which may be misinterpreted as dementia. The key sleep disorders impacting patients with dementia include insomnia, hypersomnolence, circadian rhythm misalignment, sleep disordered breathing, motor disturbances of sleep such as periodic leg movement disorder of sleep and restless leg syndrome, and parasomnias, mostly in the form of rapid eye movement (REM) sleep behavior disorder (RBD). RBD is a pre-clinical marker for a class of neurodegenerative diseases, the "synucleinopathies", and requires formal polysomnographic evaluation. Untreated sleep disorders may exacerbate cognitive and behavioral symptoms in patients with dementia and are a source of considerable stress for bed partners and family members. When left untreated, sleep disturbances may also increase the risk of injury at night, compromise health-related quality of life, and precipitate and accelerate social and economic burdens for caregivers.
authors.affiliation: Department of Neurology, UCLA Mary S. Easton Center for Alzheimer's Disease Research, David Geffen School of Medicine at UCLA, 10911 Weyburn Ave., Suite 200, Los Angeles, CA, 90095-7226, USA. vporter@mednet.ucla.edu.
authors.forename: Verna R
authors.initials: VR
authors.lastname: Porter
authors.affiliation: Department of Neurology, David Geffen School of Medicine at UCLA, 300 UCLA Medical Plaza, Suite B200, Los Angeles, CA, 90095-6975, USA. wbuxton@mednet.ucla.edu.
authors.forename: William G
authors.initials: WG
authors.lastname: Buxton
authors.affiliation: Department of Neurology, UCLA Sleep Disorders Center, David Geffen School of Medicine at UCLA, 710 Westwood Blvd., Room 1-145 RNRC, Los Angeles, CA, 90095-1769, USA. avidan@mednet.ucla.edu.
authors.forename: Alon Y
authors.initials: AY
authors.lastname: Avidan
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000209:etiology; D002940:Circadian Rhythm; D003071:Cognition; D003704:Dementia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003937:Diagnosis, Differential; D006801:Humans; D016743:Mental Competency / Q000523:psychology; D009483:Neuropsychological Tests; D017286:Polysomnography / Q000379:methods; D011788:Quality of Life; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012895:Sleep, REM
keywords: Aging; Alpha synucleinopathies; Alzheimer’s dementia; Dementia; Neurodegenerative disease; REM sleep behavior disorder; Sleep; Sleep disorders; Sun-downing