阿尔兹海默病睡眠障碍的机制与治疗进展

Mechanism and treatment of sleep disorders in Alzheimer's disease

阿尔兹海默病(Alzheimer's disease,AD)是一种与年龄高度相关的、以进行性认知功能障碍和记忆力损害为主的中枢神经系统变性疾病,又称为老年性痴呆。调查显示,40%以上的AD患者合并不同程度的睡眠问题(睡眠结构改变、昼夜节律紊乱或睡眠呼吸障碍),可导致患者认知与行为能力加速恶化、神经-内分泌系统功能失调、情绪易怒和低落,甚至导致死亡。由于目前AD的一线治疗药物疗效欠佳,且近10余年几乎所有的AD新药研发无明显阳性结果,故如何有效改善AD伴随症状亦成为临床延缓AD进展的治疗重点之一。近5年针对睡眠与AD的关系及相关药物、非药物治疗等研究日益受到重视。本文就目前对于AD患者睡眠障碍的发病机制、治疗现状作一综述。

Alzheimer＆#39;s disease （AD） is a neurodegenerative disease highly correlated with age and characterized by progressive impairment in memory and cognition ,also known as senile dementia .Survey shows more than 40% of AD patients with varying degrees of sleep problems （sleep structure changes ,circadian rhythm disorder ,sleep apnea and so on） ,which can lead to accelerated cognitive and behavioral deterioration ,the nerve‐endocrine system dysfunction ,emotional irritability and depression ,and even death .Due to the poor efficacy of first‐line treatment drugs ,and no significant positive results were achieved in AD drug development over the past ten years ,how to effectively improve the associated symptoms of AD has become one of the therapeutic targets for delaying the progression of AD .In the past 5 years ,research on the relationship between sleep and AD ,related drugs and non‐drug therapy has attracted increasing attention .In this paper ,a review of the pathogenesis and clinical treatment of sleep disorders in patients with AD will be presented .