Gina Johnson
Lewy body dementia (LBD) is a neurodegenerative disease that affects sleep. It is characterised by poor sleep quality, excessive daytime sleepiness, and rapid eye movement (REM) behaviour disorder.
REM sleep behaviour disorder (RBD) is a parasomnia in which the normal paralysis of REM sleep is lost, causing patients to 'act out' their dreams. RBD is a core clinical feature of LBD and may occur either in advance or simultaneously with the onset of LBD.
The presence of RBD in men with dementia is a strong indicator of LBD over Alzheimer's disease. RBD is found in up to 76% of LBD patients.
RBD is also a powerful early sign of Parkinson's disease and multiple system atrophy. The high risk of phenoconversion to overt neurodegenerative disease in RBD provides an opportunity to directly observe the evolution of prodromal LBD and to identify which cognitive variables are the strongest predictors of evolving dementia.
The strongest predictors of dementia in iRBD include reduced attention and executive function, particularly performance on the Trail Making Test Part B. In phenoconverters, the onset of cognitive decline begins up to 10 years prior to phenoconversion. Changes in verbal memory best differentiated between LBD and PD subtypes.
What You'll Learn
- Lewy body dementia (LBD) is associated with a range of sleep symptoms, including poor sleep quality, excessive daytime sleepiness, and rapid eye movement behaviour disorder
- Sleep disturbances are common in LBD, with up to 90% of people with LBD experiencing at least one form of sleep disturbance
- The underlying mechanisms of sleep disturbances in LBD are unclear, but it is thought that Lewy body pathology in certain areas of the brain may be involved
- Treatment of sleep disturbances in LBD is challenging due to the limited number of high-quality randomised controlled trials
- Non-pharmacological interventions such as bright light therapy and deep brain stimulation have shown some promise in treating sleep disturbances in LBD
Lewy body dementia (LBD) is associated with a range of sleep symptoms, including poor sleep quality, excessive daytime sleepiness, and rapid eye movement behaviour disorder
Poor sleep quality
Poor sleep quality is a common symptom of LBD, with up to 90% of people with LBD experiencing some form of sleep disturbance. This is more common and severe in LBD than in other dementias.
Excessive daytime sleepiness
Excessive daytime sleepiness (EDS) is also more common and severe in LBD than in other dementias, with up to 80% of people with dementia with Lewy bodies (DLB) experiencing EDS.
Rapid eye movement behaviour disorder
Rapid eye movement behaviour disorder (RBD) is a parasomnia in which the normal paralysis of rapid eye movement (REM) sleep is lost, causing patients to 'act out' their dreams. RBD is a core feature of LBD and may occur either before or at the same time as the onset of LBD. It is present in approximately 80% of people with DLB.
REM vs Core Sleep: Which Stage is Better?
You may want to see also
Sleep disturbances are common in LBD, with up to 90% of people with LBD experiencing at least one form of sleep disturbance
Sleep disturbances are common in Lewy body dementia (LBD), with up to 90% of people with LBD experiencing at least one form of sleep disturbance. These disturbances can include poor sleep quality, excessive daytime sleepiness, and rapid eye movement behaviour disorder (RBD). RBD is a parasomnia in which the normal paralysis of REM sleep is lost, causing patients to 'act out' their dreams. It is a core clinical feature of LBD and may occur either in advance or simultaneously with the onset of LBD. The presence of RBD in men with dementia is a strong indicator of LBD over Alzheimer's disease.
RBD can be either idiopathic or secondary to other neurological disorders and medications. Idiopathic RBD is cryptogenic since Lewy bodies were demonstrated by autopsy in two cases of presumptive idiopathic RBD. Idiopathic RBD is also found to have α-synuclein accumulation and thought to be the prodromal stage of many neurodegenerative disorders, such as PD and LBD, multiple system atrophy (MSA), and a pure autonomic failure.
The underlying mechanisms of sleep disturbances in LBD are unclear. However, it is known that the involvement of cholinergic deficits in LBD and cholinesterase inhibitors are beneficial for better clinical courses by lowering the choline degradation.
LBD is associated with a range of sleep symptoms, including subjective sleep disturbances, including poor sleep quality, insomnia, EDS, sleep apnea and RLS, which are more frequently observed in LBD than in other dementias, including AD.
How to Hack Your Sleep: Skip to REM
You may want to see also
The underlying mechanisms of sleep disturbances in LBD are unclear, but it is thought that Lewy body pathology in certain areas of the brain may be involved
The underlying mechanisms of sleep disturbances in Lewy body dementia (LBD) are unclear, but it is thought that Lewy body pathology in certain areas of the brain may be involved.
Lewy body pathology in the brainstem and medulla, which are involved in controlling REM sleep, is thought to be a cause of REM sleep behaviour disorder (RBD). RBD is a parasomnia in which the normal paralysis of REM sleep is lost, causing patients to 'act out' their dreams. RBD is a core clinical feature of LBD and may occur either in advance or simultaneously with the onset of LBD.
RBD is associated with a loss of REM sleep atonia control, which is believed to be caused by Lewy body pathology in the pontine and medullary structures. This loss of control is thought to be caused by the accumulation of Lewy bodies in the pontine and medullary structures, which results in RSWA and RBD.
Talking to Someone in REM Sleep: Is it Possible?
You may want to see also
Treatment of sleep disturbances in LBD is challenging due to the limited number of high-quality randomised controlled trials
Treatment of sleep disturbances in Lewy body dementia (LBD) is challenging due to the limited number of high-quality randomised controlled trials. The current evidence base is very weak, and the treatment of sleep disturbances in LBD is based on findings from Parkinson's disease and idiopathic REM sleep behaviour disorder (iRBD) rather than LBD populations. High-quality LBD-specific treatment studies are urgently needed.
REM Sleep and Seizures: A Complex Connection
You may want to see also
Non-pharmacological interventions such as bright light therapy and deep brain stimulation have shown some promise in treating sleep disturbances in LBD
Bright light therapy has been shown to improve sleep disturbances in patients with Lewy body dementia (LBD). In a study, bright light therapy was used to treat a patient with LBD, and it was found that the patient's sleep disturbances improved. The patient was exposed to 10,000 lux of light for 6 weeks, and the results showed improvements in both depression and sleep measures.
Deep brain stimulation has also been found to be a promising treatment for sleep disturbances in LBD. A study found that deep brain stimulation of the subthalamic nucleus improved sleep and daytime sleepiness in LBD patients. However, the study's primary aim was to assess the safety and effects of the procedure on episodic memory, and there are concerns about the adverse effects of this procedure.
Understanding Deep and REM Sleep: Which is More Vital?
You may want to see also
Frequently asked questions
Lewy body dementia (LBD) is a neurodegenerative disease that affects sleep. It is the third most common cause of dementia, and the typical clinical presentation is rapidly progressive cognitive impairment. LBD is often discussed simultaneously with Parkinson's disease dementia (PDD) because of the overlaps in pathological features, such as the presence of Lewy bodies and intracellular inclusions of α-synuclein and ubiquitin in the brain stem, limbic area, forebrain, and neocortex.
REM sleep is one of the two main types of sleep, the other being non-rapid eye movement (NREM) sleep. REM sleep is characterised by rapid eye movement, and the absence of muscle tone. It is also known as paradoxical sleep because the brain is highly active while the body is immobilised.
RBD is a parasomnia, with abnormal dream-enacting behaviour during REM sleep. It is either idiopathic or secondary to other neurologic disorders and medications. RBD is a core clinical feature of LBD and may occur either in advance or simultaneously with the onset of LBD.
