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Clinical Significance of Sleep‐Disordered Breathing in Alzheimer's Disease
Author(s) -
Hoch Carolyn C.,
Reynolds Charles F.,
Nebes Robert D.,
Kupfer David J.,
Berman Susan R.,
Campbell Donna
Publication year - 1989
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1989.tb05872.x
Subject(s) - medicine , apnea , abnormality , sleep apnea , sleep disordered breathing , alzheimer's disease , dementia , cardiology , disease , obstructive sleep apnea , psychiatry
In a study of 15 probable Alzheimer's patients and 12 healthy elderly control subjects, Alzheimer's patients had a significantly higher apnea index (patients versus controls, mean ± SD: 6.3 ± 6.6 vs 1.8 ± 2.7, P < .05) and greater maximal duration of apnea (patients versus controls, median: 50.0 vs 28.5 seconds, P < .001), but no significant increase in oxyhemoglobin desaturation compared with controls. (The accepted normal threshold for abnormality is an apnea index more than 5.) Although three of seven psychometric tests (odd‐even, category retrieval, face‐hand test) showed diurnal effects on one or more of their subscores, with Alzheimer's patients having significantly poorer scores at the AM than at PM testing, overnight change scores in the psychometric tests were not significantly correlated with severity of sleep‐disordered breathing. Further, only 18.1% of the disruptive (ie, requiring intervention) nocturnal behaviors of the Alzheimer's patients were temporally linked to sleep‐disordered breathing. The current data suggest that sleep‐disordered breathing in nonmedicated Alzheimer's patients is relatively mild and is not a predictor of either overnight mental status changes, of disruptive nocturnal behaviors, or of daytime behavioral fluctuations. Additional studies of more severely demented patients and possibly of sleeping pill effects would be useful in further evaluating the role of sleep apnea in Alzheimer behavioral changes.