Sleep Disturbances in Patients With Mild-Stage Alzheimer's Disease
Abstract
We examined the ability of sleep/wake measures to discriminate 45 control subjects from 44 mild Alzheimer's disease (AD) patients. Sleep fragmentation was observed as indicated by significant increases in time awake (37-52%) and number of awakenings (31-36%) during the night as compared to controls. Further, slow wave sleep (SWS) was significantly reduced (22%) in AD patients relative to controls. These findings are consistent with our earlier observations of increased wakefulness and decreased SWS in mild-moderate, moderate-severe, and severe stage AD patients. However, when we used these sleep/wake stage measures in discriminant analyses to classify the current AD subjects vs control subjects, the analyses failed to confirm our earlier high classification rate (90%). The present groups were discriminated at overall classification rates of only 63-67%. We conclude that while sleep/wake patterns are significantly disturbed in AD, this phenomenon is not diagnostically useful for discrimination of mild stage AD.
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In patients with AD, sleep disruptions tend to begin after diagnosis.
“in patients with AD, sleep disruptions tend to begin after diagnosis261”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [261]
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Yesavage, J. A., Friedman, L., KRAEMER, H. C., et al. (1998) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/089198879801100103 · Cited by 44 · see citing works
Linking activity dyshomeostasis and sleep disturbances in Alzheimer disease
Slutsky, I. (2024) · Nature reviews. Neuroscience · doi:10.1038/s41583-024-00797-y · Cited by 43 · see citing works
The effect of a walled garden on behavior of individuals with Alzheimer's
Mather, J. A., Nemecek, D., & Oliver, K. (1997) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331759701200603 · Cited by 39 · see citing works
Sleep, Breathing, and Neurological Disorders
Chokroverty, S. (1994) · Elsevier eBooks · doi:10.1016/b978-0-7506-9002-7.50025-2 · Cited by 40 · see citing works
Multiple Occupancy Versus Private Rooms on Dementia Care Units
Morgan, D., & Stewart, N. J. (1998) · Environment and Behavior · doi:10.1177/001391659803000404 · Cited by 38 · see citing works
Bidirectional relationships between sleep and amyloid-beta in the hippocampus
Dufort‐Gervais, J., Mongrain, V., & Brouillette, J. (2018) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2018.06.009 · Cited by 36 · see citing works
Liguori, C., Mercuri, N. B., Nuccetelli, M., Izzi, F., Bernardini, S., & Placidi, F. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180769 · Cited by 37 · see citing works
“Although sleep disturbances are associated with a more evident cognitive impairment in patients with AD [32–34], there is scarce evidence linking nocturnal sleep alteration to NPS in AD.”
Age trends in the sleep EEG of healthy older men and women
Larsen, L. H., Moe, K. E., Vitiello, M. V., & Prinz, P. N. (1995) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1995.tb00165.x · Cited by 37 · see citing works
Self-citationEpidemiology and clinical features of sleep disorders in extrapyramidal disease
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“[168] Vitiello MV, Prinz PN, Williams DE, et al.”
BackgroundIntegrating Sleep and Alzheimer’s Disease Pathophysiology: Hints for Sleep Disorders Management
Proserpio, P., Arnaldi, D., Nobili, F. M., & Nobili, L. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180041 · Cited by 34 · see citing works
“…AD dementia patients have shown to exhibit an increased number and duration of awakenings, an increased arousal index, an increased sleep latency, a decreased sleep efficiency and total sleep time, an increased light sleep and a decreased SWS as well as a reduction of REM sleep [3, 57, 58].”
Kent, B. A., Michalik, M. J., Marchant, E. G., Yau, K. W., Feldman, H., Mistlberger, R. E., & Nygaard, H. B. (2019) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2019.01.010 · Cited by 33 · see citing works
Ancoli‐Israel, S., & Vitiello, M. V. (2006) · American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000200973.93494.aa · Cited by 37 · see citing works
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Sleep deficiency as a driver of cellular stress and damage in neurological disorders
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“Common sleep problems experienced with age include insomnia, sleep fragmentation, sleep disordered breathing, disrupted circadian rhythms, and excessive daytime sleepiness, which are exacerbated with the development and progression of AD [43,70,71].”
BackgroundLee, Y. F., Russ, A., Zhao, Q., Perle, S. J., Maci, M., Miller, M. R., Hou, S. S., Algamal, M., Zhao, Z., Li, H., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-40402-3 · Cited by 30 · see citing works
“Disruptions in deep non-rapid eye movement (NREM) slow-wave sleep (SWS) are evident in patients with mild AD 15,16 and in individuals with mild cognitive impairment (MCI) 17 .”
BackgroundRole of sleep in neurodegeneration: the consensus report of the 5th Think Tank World Sleep Forum
Ferini‐Strambi, L., Liguori, C., Lucey, B. P., Mander, B. A., Spira, A. P., Videnović, A., Baumann, C. R., Franco, O. H., Fernandes, M., Gnarra, O., et al. (2023) · Neurological Sciences · doi:10.1007/s10072-023-07232-7 · Cited by 32 · see citing works
“Compared to cognitively normal older adults, those with dementia exhibit an exaggeration of the aging-related changes in sleep continuity and duration, and deterioration of REM and SWS just described [81–85].”
Does abnormal non-rapid eye movement sleep impair declarative memory consolidation?
Lu, W., & Göder, R. (2011) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2011.08.001 · Cited by 31 · see citing works
- Authors
- Vitiello, M. V., Prinz, P. N., Williams, D. E., Frommlet, M. S., & Ries, R. K.
- Affiliations
- University of Washington (US)
- Venue
- Journal of Gerontology
- Publisher
- Oxford University Press (OUP)
- Published
- 1990-07-01
- Volume
- 45
- Issue
- 4
- Pages
- M131-M138
- ISSN
- 0022-1422 (ISSN-L)
- OpenAlex
- W2121766792
- Cited by
- 223
- References
- 0
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 7 · 2023: 15 · 2022: 11 · 2021: 12 · 2020: 11 · 2019: 13 · 2018: 8 · 2017: 7 · 2016: 7 · 2015: 5 · 2014: 8 · 2013: 4 · 2012: 10
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gerontology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh045186-03, 5r23ag004348-03)
- National Institute on Aging (AG04348)
- National Institute of Mental Health (MH-45186, MH33688)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- Alzheimer's disease, mild Alzheimer's disease, sleep disorders, sleep fragmentation, slow-wave sleep, wakefulness, nocturnal awakenings, diagnostic value, discriminant analysis
- MeSH terms
- Aged, Alzheimer Disease, Female, Humans, Male, Psychiatric Status Rating Scales, Sleep Wake Disorders, Sleep Stages
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