Role of Sleep in Dementia and Associated Comorbidities: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a review published in the journal Aging that was designed to provide a comprehensive understanding of the interplay between sleep and cognitive decline.

The study

Investigators compiled findings from recent studies on how sleep disturbances (eg, insomnia, nocturnal wandering, circadian rhythm disorders) can worsen dementia and accelerate cognitive decline. They also explored the mechanisms by which dementia-related comorbidities exacerbate sleep disturbances and cognitive impairment in people with dementia. Comorbidities included cardiovascular disease (CVD), diabetes, anxiety/depression, and thyroid disorders.

The findings

According to the review, sleep disturbances affect approximately 50-70% of dementia patients, a rate that far exceeds that of the general elderly population. The authors note that these sleep issues not only exacerbate cognitive decline but also contribute to increased caregiver stress and burnout. They also observed a bidirectional relationship between sleep and dementia-related comorbidities, highlighting the importance of a holistic approach to managing dementia.

Non-pharmacological interventions such as cognitive-behavioral therapy for insomnia (CBT-I), light therapy, and structured sleep routines were recommended by investigators. They also stated that modifications to the sleep environment—such as reducing noise, controlling light exposure, and maintaining a consistent sleep-wake schedule—can significantly improve sleep quality for patients with dementia. Pharmacological treatments may be necessary in some cases but require careful management. The review also stressed the importance of a multidisciplinary approach involving neurologists, geriatricians, sleep specialists, and primary care providers.

Authors' comments

"Integrated treatment approaches that address both cognitive and sleep-related challenges are essential for improving patient outcomes. The review also underscores the need for further research to develop targeted interventions that can effectively manage sleep disturbances in dementia, thereby enhancing the quality of life for both patients and caregivers."

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