RSS-Feed abonnieren
DOI: 10.1055/s-2005-867072
Sleep and Neurodegenerative Diseases
Publikationsverlauf
Publikationsdatum:
29. März 2005 (online)
![](https://www.thieme-connect.de/media/sin/200501/lookinside/thumbnails/10.1055-s-2005-867072-1.jpg)
ABSTRACT
Sleep disturbances are common in neurodegenerative diseases. Disturbed sleep can result in fatigue, irritability, morning headaches, impaired motor and cognitive skills, depression, and daytime somnolence. The major sleep complaints include: insomnia, hypersomnia, parasomnia, excessive nocturnal motor activity, circadian sleep-wake rhythm disturbance, and respiratory dysrhythmia. The pathogenetic mechanisms of sleep disturbances may be secondary to direct structural alteration of the sleep-wake generating neurons or from several other indirect mechanisms. At the biochemical level, neurodegenerative diseases may be largely classified as tauopathies, α-synucleinopathies, and other diseases. Overnight polysomnography (PSG) and multiple sleep latency test are the two most important diagnostic laboratory tests in the evaluation of sleep disturbances. Management of sleep disturbances is complex and is based primarily on the nature of the sleep disturbance. The clinical profiles, pathogenetic mechanisms, PSG findings, and management issues are discussed here with reference to some common neurodegenerative diseases.
KEYWORDS
Neurodegenerative disease - sleep disturbance - polysomnography (PSG)
REFERENCES
- 1 Boeve B F, Silber M H, Parisi J E et al.. Synucleinopathy pathology and REM sleep behavior disorder plus dementia or parkinsonism. Neurology. 2003; 61 40-45
- 2 Schenck C H, Mahowald M W. A polysomnographic, neurologic, psychiatric and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder (RBD): sustained clonazepam efficacy in 89.5% of 57 treated patients. Cleve Clin J Med. 1990; 57(suppl) 9-23
- 3 Vitiello M V, Prinz P N. Alzheimer's disease. Sleep and sleep/wake patterns. Clin Geriatr Med. 1989; 5 289-299
- 4 Moe K E, Vitiello M V, Larsen L H, Prinz P N. Symposium: Cognitive processes and sleep disturbances: sleep/wake patterns in Alzheimer's disease: relationships with cognition and function. J Sleep Res. 1995; 4 15-20
- 5 Taylor J L, Friedman L, Sheikh J, Yesavage J A. Assessment and management of “sundowning” phenomena. Semin Clin Neuropsychiatry. 1997; 2 113-122
- 6 Vitiello M V, Bliwise D L, Prinz P N. Sleep in Alzheimer's disease and the sundown syndrome. Neurology. 1992; 42(Suppl 6) 83-94
- 7 Chokroverty S. Sleep, breathing, and neurologic disorders. In: Chokroverty S Sleep Disorders Medicine: Basic Science, Technical Considerations, and Clinical Aspects. 2nd ed Boston; Butterworth Heinemann 1999: 509-571
- 8 Bliwise D L. Sleep apnea, APOE4 and Alzheimer's disease: 20 years and counting?. J Psychosom Res. 2002; 53 539-546
- 9 Grace J B, Walker M P, McKeith I G. A comparison of sleep profiles in patients with dementia with lewy bodies and Alzheimer's disease. J Geriatr Psychiatry. 2000; 15 1028-1033
- 10 Bahro M, Riemann D, Stadtmuller G et al.. REM sleep parameters in the discrimination of probable Alzheimer's disease from old-age depression. Biol Psychiatry. 1993; 34 482-486
- 11 Dykierek P, Stadtmuller G, Schramm P et al.. The value of REM sleep parameters in differentiating Alzheimer's disease from old-age depression and normal aging. J Psychiatr Res. 1998; 32 1-9
- 12 Rajput A, Rajput A H. Progressive supranuclear palsy: clinical features, pathophysiology and management. Drugs Aging. 2001; 18 913-925
- 13 Aldrich M, Foster N L, White R F, Bluemlein L, Prokopowicz G. Sleep abnormalities in progressive supranuclear palsy. Ann Neurol. 1989; 25 577-581
- 14 Chokroverty S. Sleep and degenerative neurologic disorders. Neurol Clin. 1996; 14 807-826
- 15 Perret J L, Jouvet M. Sleep study of progressive supranuclear paralysis. Electroencephalogr Clin Neurophysiol. 1980; 49 323-329
- 16 De Bruin V S, Machado C, Howard R S, Hirsch N P, Lees A J. Nocturnal and respiratory disturbances in Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). Postgrad Med J. 1996; 72 293-296
- 17 Wetter T C, Brunner H, Collado-Seidel V, Trenkwalder C, Winkelmann J. Sleep and periodic limb movements in corticobasal degeneration. Sleep Med. 2002; 3 33-36
- 18 Iriarte J, Alegre M, Arbizu J, de Castro P. Unilateral periodic limb movements during sleep in corticobasal degeneration. Mov Disord. 2001; 16 1180-1183
- 19 Partinen M. Sleep disorder related to Parkinson's disease. J Neurol. 1997; 244(Suppl 1) S3-S6
- 20 Kumar S, Bhatia M, Behari M. Sleep disorders in Parkinson's disease. Mov Disord. 2002; 17 775-781
- 21 Factor S A, McAlarney T, Sanchez-Ramos J R et al.. Sleep disorders and sleep effect in Parkinson's disease. Mov Disord. 1990; 5 280-285
- 22 Young A, Home M, Churchward T, Freezer N, Holmes P, Ho M. Comparison of sleep disturbance in mild versus severe Parkinson's disease. Sleep. 2002; 25 573-577
- 23 Happe S, Schrodl B, Faltl M et al.. Sleep disorders and depression in patients with Parkinson's disease. Acta Neurol Scand. 2001; 104 275-280
- 24 Schenck C H, Mahowald M W. REM sleep parasomnias. Neurol Clin. 1996; 14 697-720
- 25 Schenck C H, Bundlie S R, Mahowald M W. Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder. Neurology. 1996; 46 388-393
- 26 Wetter T C, Trenkwalder C, Gershanik O et al.. Polysomnographic measures in Parkinson's disease: a comparison between patients with and without REM sleep disturbances. Wien Klin Wochenschr. 2001; 113 249-253
- 27 Frucht S J, Rogers J D, Greene P E et al.. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology. 1999; 52 1908-1910
- 28 Frucht S J, Greene P E, Fahn S. Sleep episodes in Parkinson's disease: a wake-up call. Mov Disord. 2000; 15 601-603
- 29 O'Suilleabhain P E, Dewey R B Jr. Contributions of dopaminergic drugs and disease severity to daytime sleepiness in Parkinson disease. Arch Neurol. 2002; 59 986-989
- 30 Larsen J P, Tandberg E. Sleep disorders in patients with Parkinson's disease: epidemiology and management. CNS Drugs. 2001; 15 267-275
- 31 Paus S, Brecht H M, Koster J, Seeger G, Klockgether T, Wullner U. Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease. Mov Disord. 2003; 18 659-667
- 32 Ondo W G, Dat Vuong K, Khan H, Atassi F, Kwak C, Jankovic J. Daytime sleepiness and other sleep disorders in Parkinson's disease. Neurology. 2001; 57 1392-1396
- 33 Arnulf I, Konofal E, Merino-Andreu M et al.. Parkinson's disease and sleepiness: an integral part of PD. Neurology. 2002; 58 1019-1024
- 34 Rye D B, Bliwise D L, Dihenia B, Gurecki P. Daytime sleepiness in Parkinson's disease. J Sleep Res. 2000; 9 63-69
- 35 McKeith I G, Galasko D, Kosaka K et al.. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology. 1996; 47 1113-1124
- 36 Grace J B, Walker M P, McKeith I G. A comparison of sleep profiles in patients with dementia with lewy bodies and Alzheimer's disease. Int J Geriatr Psychiatry. 2000; 15 1028-1033
- 37 Boeve B F, Silber M H, Ferman T J et al.. REM sleep behavior disorder and degenerative dementia: an association likely reflecting Lewy body disease. Neurology. 1998; 51 363-370
- 38 McKeith I G, Perry E K, Perry R H. Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consortium on Dementia with Lewy Bodies. Neurology. 1999; 53 902-905
- 39 Gilman S, Low P, Quinn N et al.. Consensus on the diagnosis of multi-system atrophy. Neurologia. 1999; 14 425-428
- 40 Plazzi G, Corsini R, Provini F et al.. REM sleep behavior disorders in multiple system atrophy. Neurology. 1997; 48 1094-1097
- 41 Tison F, Wenning G, Quinn N, Smith S. REM sleep behavior disorder as the presenting symptom of multiple system atrophy. J Neurol Neurosurg Psychiatry. 1995; 58 379-380
- 42 Plazzi G, Cortelli P, Montagna P et al.. REM sleep behaviour disorder differentiates pure autonomic failure from multiple system atrophy with autonomic failure. J Neurol Neurosurg Psychiatry. 1998; 64 683-685
- 43 Bannister R, Gibson W, Michaels L, Oppenheimer D R. Laryngeal abductor paralysis in multiple system atrophy. A report on three necropsied cases, with observations on the laryngeal muscles and the nuclei ambigui. Brain. 1981; 104 351-368
- 44 Cunchillos J D, DeAndres I. Participation of the cerebellum in the regulation of the sleep-wakefulness cycle: results in cerebellectomized cats. Electroencephalogr Clin Neurophysiol. 1982; 53 549-558
- 45 Kitamura J, Kubuki Y, Tsuruta K, Kurihara T, Matsukura S. A new family with Joseph disease in Japan. Homovanillic acid, magnetic resonance, and sleep apnea studies. Arch Neurol. 1989; 46 425-428
- 46 Chokroverty S, Sachdeo R, Masdeu J. Autonomic dysfunction and sleep apnea in olivopontocerebellar degeneration. Arch Neurol. 1984; 41 926-931
- 47 Salazar-Grueso E F, Rosenberg R S, Roos R P. Sleep apnea in olivopontocerebellar degeneration: treatment with trazodone. Ann Neurol. 1988; 23 399-401
- 48 Quera-Salva M A, Guilleminault C. Olivopontocerebellar degeneration, abnormal sleep, and REM sleep without atonia. Neurology. 1986; 36 576-577
- 49 Kushida C A, Clerk A A, Kirsch C M, Hotson J R, Guilleminault C. Prolonged confusion with nocturnal wandering arising from NREM and REM sleep: a case report. Sleep. 1995; 18 757-764
- 50 Abele M, Burk K, Laccone F, Dichgans J, Klockgether T. Restless legs syndrome in spinocerebellar ataxia types 1, 2, and 3. J Neurol. 2001; 248 311-314
- 51 Myers R H, Sax D S, Schoenfeld M et al.. Late onset of Huntington's disease. J Neurol Neurosurg Psychiatry. 1985; 48 530-534
- 52 Askenasy J J. Sleep patterns in extrapyramidal disorders. Int J Neurol. 1981; 15 62-76
- 53 Jankel W R, Allen R P, Niedermeyer E, Kalsher M J. Polysomnographic findings in dystonia musculorum deformans. Sleep. 1983; 6 281-285
- 54 Segawa M, Hosaka A, Miyagawa F et al.. Hereditary progressive dystonia with marked diurnal fluctuation. Adv Neurol. 1976; 14 215-233
- 55 Ichinose H, Ohye T, Takahashi E et al.. Hereditary progressive dystonia with marked diurnal fluctuation caused by mutations in the GTP cyclohydrolase I gene. Nat Genet. 1994; 8 236-242
- 56 Kimura K, Tachibana N, Kimura J, Shibasaki H. Sleep-disordered breathing at an early stage of amyotrophic lateral sclerosis. J Neurol Sci. 1999; 164 37-43
- 57 Barthlen G M, Lange D J. Unexpectedly severe sleep and respiratory pathology in patients with amyotrophic lateral sclerosis. Eur J Neurol. 2000; 7 299-302
- 58 Takekawa H, Kubo J, Miyamoto T, Miyamoto M, Hirata K. Amyotrophic lateral sclerosis associated with insomnia and the aggravation of sleep-disordered breathing. Psychiatry Clin Neurosci. 2001; 55 263-264
- 59 Zweig R M, Jankel W R, Hedreen J C et al.. The pedunculopontine nucleus in Parkinson's disease. Ann Neurol. 1989; 26 41-46
- 60 Jellinger K A. Pathology of Parkinson's disease: changes other than the nigrostriatal pathway. Mol Chem Neuropathol. 1991; 14 153-197
- 61 Paulus W, Jellinger K. The neuropathologic basis of different clinical subgroups of Parkinson's disease. J Neuropathol Exp Neurol. 1991; 50 743-755
- 62 Wenning G K, Tison F, Shlomo B et al.. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord. 1997; 12 133-147
- 63 Papp M I, Lantos P L. The distribution of oligodendroglial inclusions in multiple system atrophy and its relevance to clinical symptomatology. Brain. 1994; 117 235-243
- 64 Gilman S, Koeppe R A, Chervin R D et al.. REM sleep behavior disorder is related to striatal monoaminergic deficit in MSA. Neurology. 2003; 61 29-34
- 65 Gilman S, Chervin R D, Koeppe R A et al.. Obstructive sleep apnea is related to a thalamic cholinergic deficit in MSA. Neurology. 2003; 61 35-39
- 66 Buee L, Bussiere T, Buee-Scherrer V, Delacourte A, Hof P R. Tau protein isoforms, phosphorylation and role in neurodegenerative disorders. Brain Res Brain Res Rev. 2000; 33 95-130
- 67 Forman M S, Lee V M, Trojanowski J Q. New insights into genetic and molecular mechanisms of brain degeneration in tauopathies. J Chem Neuroanat. 2000; 20 225-244
- 68 Duyckaerts C, Verny M, Hauw J J. Recent neuropathology of parkinsonian syndromes [in French]. Rev Neurol (Paris). 2003; 159 S11-S18
- 69 Kruger R, Muller T, Riess O. Involvement of alpha-synuclein in Parkinson's disease and other neurodegenerative disorders. J Neural Transm. 2000; 107 31-40
- 70 Chung K K, Dawson V L, Dawson T M. New insights into Parkinson's disease. J Neurol. 2003; 250(suppl 3) 15-24
- 71 Doherty M J, Bird T D, Leverenz J B. Alpha-synuclein in motor neuron disease: an immunohistologic study. Acta Neuropathol (Berl). 2004; 107 169-175
- 72 Chokroverty S. Sleep, breathing, and neurologic disorders. In: Chokroverty S Sleep Disorders Medicine: Basic Science, Technical Considerations, and Clinical Aspects. 2nd ed Boston; Butterworth Heinemann 1999 517: 519-520
- 73 Tracik F, Ebersbach G. Sudden daytime sleep onset in Parkinson's disease: polysomnographic recordings. Mov Disord. 2001; 16 500-506
- 74 Hansotia P, Wall R, Berendes J. Sleep disturbances and severity of Huntington's disease. Neurology. 1985; 35 1672-1674
- 75 Wiegand M, Moller A A, Lauer C J et al.. Nocturnal sleep in Huntington's disease. J Neurol. 1991; 238 203-208
- 76 Silvestri R, Raffaele M, De Domenico P et al.. Sleep features in Tourette's syndrome, neuroacanthocytosis and Huntington's chorea. Neurophysiol Clin. 1995; 25 66-77
- 77 Montplaisir J, Petit D, Decary A et al.. Sleep and quantitative EEG in patients with progressive supranuclear palsy. Neurology. 1997; 49 999-1003
- 78 Massetani R, Arena R, Bonuccelli U, Salerno P, Muratorio A. Sleep in progressive supranuclear palsy. Riv Patol Nerv Ment. 1982; 103 215-224
- 79 Pareja J A, Caminero A B, Masa J F, Dobato J L. A first case of progressive supranuclear palsy and pre-clinical REM sleep behavior disorder presenting as inhibition of speech during wakefulness and somniloquy with phasic muscle twitching during REM sleep. Neurologia. 1996; 11 304-306
- 80 Olson E J, Boeve B F, Silber M H. Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. Brain. 2000; 123 331-339
- 81 Jankel W R, Allen R P, Niedermeyer E, Kalsher M J. Polysomnographic findings in dystonia musculorum deformans. Sleep. 1983; 6 281-285
- 82 Jankel W R, Niedermeyer E, Graf M, Kalsher M. Polysomnography of torsion dystonia. Arch Neurol. 1984; 41 1081-1083
- 83 Wein A, Golubev V. Polygraphic analysis of sleep in dystonia musculorum deformans. Waking Sleeping. 1979; 3 41-50
- 84 Fish D R, Allen P J, Sawyers D, Marsden C D. Sleep spindles in torsion dystonia. Arch Neurol. 1990; 47 216-218
- 85 Neil J F, Holzer B C, Spiker D G et al.. EEG sleep alterations in olivopontocerebellar degeneration. Neurology. 1980; 30 660-662
- 86 McCurry S M, Reynolds C F, Anconi-Israel S, Teri L, Vitiello M V. Treatment of sleep disturbance in Alzheimer's disease. Sleep Med Rev. 2000; 4 603-608
- 87 NCSDR Working Group . Insomnia: assessment and management in primary care. Sleep. 1999; 22 S402-S412
- 88 Drugs and insomnia: the use of medications to promote sleep. NIH Consens Statement 1983 4: 1-19
- 89 National Institutes of Health Consensus Group . National Institutes of Health Consensus Development Conference Statement: the treatment of sleep disorders of older people, March 26-28, 1990. Sleep. 1991; 14 169-177
- 90 McCurry S M, Ancoli-Israel S. Sleep dysfunction in Alzheimer's disease and other dementias. Curr Treat Options Neurol. 2003; 5 261-272
- 91 Zhdanova I V, Wurtman R J, Regan M M et al.. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab. 2001; 86 4727-4730
- 92 Olde Rikkert M G, Rigaud A S. Melatonin in elderly patients with insomnia: a systematic review. Z Gerontol Geriatr. 2001; 34 491-497
- 93 Singer C, Tractenberg R, Kaye J et al.. The ADCS clinical trial of melatonin for the sleep disturbance of Alzheimer's disease. Am J Geriatr Psychiatry. 2002; 10 S65
- 94 Bourke S C, Bullock R E, Williams T L, Shaw P J, Gibson G J. Noninvasive ventilation in ALS: indications and effect on quality of life. Neurology. 2003; 61 171-177
- 95 Zesiewicz T A, Cimino C R, Gardner N M et al.. Driving safety in Parkinson's disease. Neurology. 2000; 54(Suppl 3) A472
- 96 Boeve B F, Silber M H, Ferman T J. Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med. 2003; 4 281-284
- 97 Takeuchi N, Uchimura N, Hashizume Y et al.. Melatonin therapy for REM sleep behavior disorder. Psychiatry Clin Neurosci. 2001; 55 267-269
- 98 Fantini M L, Gagnon J F, Filipini D, Montplaisir J. The effects of pramipexole in REM sleep behavior disorder. Neurology. 2003; 61 1418-1420
- 99 Anconi-Israel S, Kripke D F, Klauber M R et al.. Periodic limb movements in sleep in community-dwelling elderly. Sleep. 1991; 14 496-500
- 100 Campbell S S, Kripke D F, Gillin J C, Hrubovcak J D. Exposure to light in healthy elderly subjects and Alzheimer's patients. Physiol Behav. 1988; 42 141-144
- 101 Sumaya I C, Rienzi B M, Deegan J F, Moss D E. Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study. J Gerontol A Biol Sci Med Sci. 2001; 56 M356-M360
Meeta H BhattM.D. Ph.D.
Director, New York Sleep Institute, 724 Second Avenue
New York, NY 10016