TY - JOUR
T1 - Role of sleep in neurodegeneration
T2 - the consensus report of the 5th Think Tank World Sleep Forum
AU - Ferini-Strambi, Luigi
AU - Liguori, Claudio
AU - Lucey, Brendan P.
AU - Mander, Bryce A.
AU - Spira, Adam P.
AU - Videnovic, Aleksandar
AU - Baumann, Christian
AU - Franco, Oscar
AU - Fernandes, Mariana
AU - Gnarra, Oriella
AU - Krack, Paul
AU - Manconi, Mauro
AU - Noain, Daniela
AU - Saxena, Smita
AU - Kallweit, Ulf
AU - Randerath, Winfried
AU - Trenkwalder, C.
AU - Rosenzweig, Ivana
AU - Iranzo, Alex
AU - Bassetti, Claudio
N1 - Publisher Copyright:
© 2023, Fondazione Società Italiana di Neurologia.
PY - 2024/2
Y1 - 2024/2
N2 - Sleep abnormalities may represent an independent risk factor for neurodegeneration. An international expert group convened in 2021 to discuss the state-of-the-science in this domain. The present article summarizes the presentations and discussions concerning the importance of a strategy for studying sleep- and circadian-related interventions for early detection and prevention of neurodegenerative diseases. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years; discussed the current challenges in the field of relationships among sleep, sleep disorders, and neurodegeneration; and identified future priorities. Sleep efficiency and slow wave activity during non-rapid eye movement (NREM) sleep are decreased in cognitively normal middle-aged and older adults with Alzheimer’s disease (AD) pathology. Sleep deprivation increases amyloid-β (Aβ) concentrations in the interstitial fluid of experimental animal models and in cerebrospinal fluid in humans, while increased sleep decreases Aβ. Obstructive sleep apnea (OSA) is a risk factor for dementia. Studies indicate that positive airway pressure (PAP) treatment should be started in patients with mild cognitive impairment or AD and comorbid OSA. Identification of other measures of nocturnal hypoxia and sleep fragmentation could better clarify the role of OSA as a risk factor for neurodegeneration. Concerning REM sleep behavior disorder (RBD), it will be crucial to identify the subset of RBD patients who will convert to a specific neurodegenerative disorder. Circadian sleep–wake rhythm disorders (CSWRD) are strong predictors of caregiver stress and institutionalization, but the absence of recommendations or consensus statements must be considered. Future priorities include to develop and validate existing and novel comprehensive assessments of CSWRD in patients with/at risk for dementia. Strategies for studying sleep-circadian-related interventions for early detection/prevention of neurodegenerative diseases are required. CSWRD evaluation may help to identify additional biomarkers for phenotyping and personalizing treatment of neurodegeneration.
AB - Sleep abnormalities may represent an independent risk factor for neurodegeneration. An international expert group convened in 2021 to discuss the state-of-the-science in this domain. The present article summarizes the presentations and discussions concerning the importance of a strategy for studying sleep- and circadian-related interventions for early detection and prevention of neurodegenerative diseases. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years; discussed the current challenges in the field of relationships among sleep, sleep disorders, and neurodegeneration; and identified future priorities. Sleep efficiency and slow wave activity during non-rapid eye movement (NREM) sleep are decreased in cognitively normal middle-aged and older adults with Alzheimer’s disease (AD) pathology. Sleep deprivation increases amyloid-β (Aβ) concentrations in the interstitial fluid of experimental animal models and in cerebrospinal fluid in humans, while increased sleep decreases Aβ. Obstructive sleep apnea (OSA) is a risk factor for dementia. Studies indicate that positive airway pressure (PAP) treatment should be started in patients with mild cognitive impairment or AD and comorbid OSA. Identification of other measures of nocturnal hypoxia and sleep fragmentation could better clarify the role of OSA as a risk factor for neurodegeneration. Concerning REM sleep behavior disorder (RBD), it will be crucial to identify the subset of RBD patients who will convert to a specific neurodegenerative disorder. Circadian sleep–wake rhythm disorders (CSWRD) are strong predictors of caregiver stress and institutionalization, but the absence of recommendations or consensus statements must be considered. Future priorities include to develop and validate existing and novel comprehensive assessments of CSWRD in patients with/at risk for dementia. Strategies for studying sleep-circadian-related interventions for early detection/prevention of neurodegenerative diseases are required. CSWRD evaluation may help to identify additional biomarkers for phenotyping and personalizing treatment of neurodegeneration.
KW - Dementia
KW - Neurodegeneration
KW - Obstructive sleep apnea
KW - Rem sleep behavior disorder
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=85179346809&partnerID=8YFLogxK
U2 - 10.1007/s10072-023-07232-7
DO - 10.1007/s10072-023-07232-7
M3 - Article
C2 - 38087143
AN - SCOPUS:85179346809
SN - 1590-1874
VL - 45
SP - 749
EP - 767
JO - Neurological Sciences
JF - Neurological Sciences
IS - 2
ER -