Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies

Elena Urrestarazu, Jorge Iriarte Sleep Unit, Clinical Neurophysiology, Clínica Universidad de Navarra, Pamplona, Navarra, SpainAbstract: Sleep and circadian disorders in Alzheimer's disease (AD) are more frequent than in the general population and appear early in the course of the...

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Autores principales:	Urrestarazu E, Iriarte J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Alzheimer disease sleep disorders melatonin circadian rhythm Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/fd1a14a2d27544788796db3c464bc7c3
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spelling	oai:doaj.org-article:fd1a14a2d27544788796db3c464bc7c32021-12-02T02:37:14ZClinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies1179-1608https://doaj.org/article/fd1a14a2d27544788796db3c464bc7c32016-01-01T00:00:00Zhttps://www.dovepress.com/clinical-management-of-sleep-disturbances-in-alzheimer39s-disease-curr-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Elena Urrestarazu, Jorge Iriarte Sleep Unit, Clinical Neurophysiology, Clínica Universidad de Navarra, Pamplona, Navarra, SpainAbstract: Sleep and circadian disorders in Alzheimer's disease (AD) are more frequent than in the general population and appear early in the course of the disease. Quality of sleep and quality of life are parallel in these patients, and such disorders also represent a heavy burden for caregivers. Although alterations in melatonin and hypocretins (orexins) seem to play a key role in the origin of these disturbances, the etiology of these disorders is multifactorial, including many factors such as environment, behavior, treatments, and comorbidities, among others. A comprehensive evaluation of sleep in each patient is essential in the design of the treatment that includes nonpharmacological and pharmacological approaches. One particularly interesting point is the possibility of a role of sleep disorders in the pathogenesis of AD, raising the possibility that treating the sleep disorder may alter the course of the disease. In this review, we present an update on the role of sleep disorders in AD, the bidirectional influence of sleep problems and AD, and treatment options. Behavioral measures, bright light therapy (BLT), melatonin, and other drugs are likely well known and correctly managed by the physicians in charge of these patients. In spite of the multiple treatments used, evidence of efficacy is scarce and more randomized double-blind placebo-controlled studies are needed. Future directions for treatment are the establishment of BLT protocols and the development of drugs with new mechanisms of action, especially hypocretin receptor antagonists, melatonin receptor agonists, and molecules that modulate the circadian clock.Keywords: Alzheimer disease, sleep disorders, melatonin, circadian rhythmUrrestarazu EIriarte JDove Medical PressarticleAlzheimer diseasesleep disordersmelatonincircadian rhythmPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol 2016, Iss Issue 1, Pp 21-33 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Alzheimer disease sleep disorders melatonin circadian rhythm Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Alzheimer disease sleep disorders melatonin circadian rhythm Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Urrestarazu E Iriarte J Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
description	Elena Urrestarazu, Jorge Iriarte Sleep Unit, Clinical Neurophysiology, Clínica Universidad de Navarra, Pamplona, Navarra, SpainAbstract: Sleep and circadian disorders in Alzheimer's disease (AD) are more frequent than in the general population and appear early in the course of the disease. Quality of sleep and quality of life are parallel in these patients, and such disorders also represent a heavy burden for caregivers. Although alterations in melatonin and hypocretins (orexins) seem to play a key role in the origin of these disturbances, the etiology of these disorders is multifactorial, including many factors such as environment, behavior, treatments, and comorbidities, among others. A comprehensive evaluation of sleep in each patient is essential in the design of the treatment that includes nonpharmacological and pharmacological approaches. One particularly interesting point is the possibility of a role of sleep disorders in the pathogenesis of AD, raising the possibility that treating the sleep disorder may alter the course of the disease. In this review, we present an update on the role of sleep disorders in AD, the bidirectional influence of sleep problems and AD, and treatment options. Behavioral measures, bright light therapy (BLT), melatonin, and other drugs are likely well known and correctly managed by the physicians in charge of these patients. In spite of the multiple treatments used, evidence of efficacy is scarce and more randomized double-blind placebo-controlled studies are needed. Future directions for treatment are the establishment of BLT protocols and the development of drugs with new mechanisms of action, especially hypocretin receptor antagonists, melatonin receptor agonists, and molecules that modulate the circadian clock.Keywords: Alzheimer disease, sleep disorders, melatonin, circadian rhythm
format	article
author	Urrestarazu E Iriarte J
author_facet	Urrestarazu E Iriarte J
author_sort	Urrestarazu E
title	Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
title_short	Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
title_full	Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
title_fullStr	Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
title_full_unstemmed	Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
title_sort	clinical management of sleep disturbances in alzheimer's disease: current and emerging strategies
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/fd1a14a2d27544788796db3c464bc7c3
work_keys_str_mv	AT urrestarazue clinicalmanagementofsleepdisturbancesinalzheimer39sdiseasecurrentandemergingstrategies AT iriartej clinicalmanagementofsleepdisturbancesinalzheimer39sdiseasecurrentandemergingstrategies
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Clinical management of sleep disturbances in Alzheimer&#39;s disease: current and emerging strategies

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Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies