Sleep disorders in Lewy body dementia: Mechanisms, clinical relevance, and unanswered questions

Alzheimers Dement. 2023 Nov;19(11):5264-5283. doi: 10.1002/alz.13350. Epub 2023 Jul 1.

Abstract

In Lewy body dementia (LBD), disturbances of sleep and/or arousal including insomnia, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, obstructive sleep apnea, and restless leg syndrome are common. These disorders can each exert a significant negative impact on both patient and caregiver quality of life; however, their etiology is poorly understood. Little guidance is available for assessing and managing sleep disorders in LBD, and they remain under-diagnosed and under-treated. This review aims to (1) describe the specific sleep disorders which occur in LBD, considering their putative or potential mechanisms; (2) describe the history and diagnostic process for these disorders in LBD; and (3) summarize current evidence for their management in LBD and consider some of the ongoing and unanswered questions in this field and future research directions.

Keywords: Lewy body dementia; Parkinson's disease dementia; daytime somnolence; dementia with Lewy bodies; excessive daytime sleepiness; insomnia; obstructive sleep apnea; rapid eye movement sleep behavior disorder; restless leg syndrome; sleep; sleep disorders; sleep disturbance.

Publication types

  • Review

MeSH terms

  • Clinical Relevance
  • Humans
  • Lewy Body Disease* / diagnosis
  • Quality of Life
  • REM Sleep Behavior Disorder*
  • Sleep
  • Sleep Wake Disorders* / etiology