Characteristic and treatment of insomnia in dementia
Nakamura, M.; Inoue, Y.
Nihon Rinsho. Japanese Journal of Clinical Medicine 71(6): 1121-1127
2013
ISSN/ISBN: 0047-1852 PMID: 23855224 Document Number: 664614
Comorbidity of sleep disturbances in dementia may lead to aggravation of cognitive and behavioral problems such as agitation, delirium and wandering in night time. Especially, Alzheimer's disease (AD) and frontotemporal dementia (FTD) frequently showed a disturbance of the sleep-wake circadian rhythm, on the other hand, dementia with Lewy bodies showed REM sleep behavior disorder. This disturbance of circadian rhythm is associated with degeneration of responsible area for sleep-wake regulation (i.e. suprachiasmatic nucleus: SCN, tuberomammillary nucleus: TMN etc.) and decreased melatonin secretion. To prevent or treat sleep disturbance in dementia, mixed modality approach with pharmacological, physical and social intervention and sleep-wake scheduling is needed. Management of the symptom is important for maintaining QOL of not only patients themselves but alsotheir caregivers.