Sleep and Alzheimer's disease: A pivotal role for the suprachiasmatic nucleus

Nov 6, 2017Sleep medicine reviews

Sleep and Alzheimer's disease: The important role of the brain's internal clock

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Abstract

More than half of Alzheimer's disease patients experience sleep-wake problems.

Alzheimer's disease is primarily associated with cognitive decline but also significant non-cognitive symptoms.
Circadian dysrhythmia in Alzheimer's patients can greatly reduce their self-care ability and contribute to caregiver exhaustion.
Sleep abnormalities have historically been viewed as a consequence of Alzheimer's pathology, but recent evidence suggests a two-way relationship between sleep and the disease.
Poor sleep may be linked to increased amyloid burden and cognitive decline in Alzheimer's patients.
Alterations in the suprachiasmatic nucleus, the body's main circadian regulator, could play a key role in the relationship between Alzheimer's pathology and sleep disturbances.

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Alzheimer's disease (AD), which accounts for most of the dementia cases, is, aside from cognitive deterioration, often characterized by the presence of non-cognitive symptoms. Society is desperately in need for interventions that alleviate the economic and social burden related to AD. Circadian dysrhythmia, one of these symptoms in particular, immensely decreases the self-care ability of AD patients and is one of the main reasons of caregiver exhaustion. Studies suggest that these circadian disturbances form the root of sleep-wake problems, diagnosed in more than half of AD patients. Sleep abnormalities have generally been considered merely a consequence of AD pathology. Recent evidence suggests that a bidirectional relationship exists between sleep and AD, and that poor sleep might negatively impact amyloid burden, as well as cognition. The suprachiasmatic nucleus (SCN), the main circadian pacemaker, is subjected to several alterations during the course of the disease. Its functional deterioration might fulfill a crucial role in the relation between AD pathophysiology and the development of sleep abnormalities. This review aims to give a concise overview of the anatomy and physiology of the SCN, address how AD pathology precisely impacts the SCN and to what degree these alterations can contribute to the progression of the disease.

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Sleep and Alzheimer's disease: A pivotal role for the suprachiasmatic nucleus

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