The Treatment of Sleep Dysfunction in Neurodegenerative Disorders


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Authors
Voysey, Zanna J. 
Barker, Roger A. 
Abstract

Abstract: Sleep dysfunction is highly prevalent across the spectrum of neurodegenerative conditions and is a key determinant of quality of life for both patients and their families. Mounting recent evidence also suggests that such dysfunction exacerbates cognitive and affective clinical features of neurodegeneration, as well as disease progression through acceleration of pathogenic processes. Effective assessment and treatment of sleep dysfunction in neurodegeneration is therefore of paramount importance; yet robust therapeutic guidelines are lacking, owing in part to a historical paucity of effective treatments and trials. Here, we review the common sleep abnormalities evident in neurodegenerative disease states and evaluate the latest evidence for traditional and emerging interventions, both pharmacological and nonpharmacological. Interventions considered include conservative measures, targeted treatments of specific clinical sleep pathologies, established sedating and alerting agents, melatonin, and orexin antagonists, as well as bright light therapy, behavioral measures, and slow-wave sleep augmentation techniques. We conclude by providing a suggested framework for treatment based on contemporary evidence and highlight areas that may emerge as major therapeutic advances in the near future.

Description

Funder: Medical Research Council; doi: http://dx.doi.org/10.13039/501100000265


Funder: National Institute for Health Research; doi: http://dx.doi.org/10.13039/501100000272

Keywords
Review, Sleep, Insomnia, Neurodegeneration, Dementia, Alzheimer’s, Parkinson’s
Journal Title
Neurotherapeutics
Conference Name
Journal ISSN
1933-7213
1878-7479
Volume Title
18
Publisher
Springer International Publishing
Sponsorship
Wellcome Trust (207799/Z/17/Z)
Asssociation of British Neurologists (G104701)
Alzheimer’s Research UK (RROU.GAAB)