Circadian Rhythm Disorders In Alzheimer’s

Alzheimer’s disease is a common condition that causes dementia. Although this is the most well-known symptom, it also manifests itself with disturbances of the circadian rhythm, or sleep-wakefulness.
Circadian Rhythm Disorders in Alzheimer's

Alzheimer’s disease is the leading cause of dementia worldwide. Among the numerous alterations it can cause, circadian rhythm disturbances stand out. 

In the different phases of the disease, in fact, there are alterations in the rhythm and quality of sleep of the individual. In this article we explain which are those associated with sleep, very frequent in Alzheimer’s sufferers.

What is Alzheimer’s?

Alzheimer’s disease is the most common form of dementia in the world population. On the planet there are about 48 million people who suffer from it and given the increase in life expectancy, it is assumed a net increase in its incidence in the years to come.

By definition, it is responsible for a cognitive decline that interferes with the person’s normal life, whether in the personal, social or work spheres. This pathology involves an accumulation of proteins in and out of neurons, as well as cell death and neuronal communication problems.

Clinically, Alzheimer’s causes memory loss, the main and best known symptom, but it can also manifest itself in many other ways. Some of the symptoms that accompany memory loss are language and behavioral changes. This involves the stages of sleep.

Tired man
Alzheimer’s impairs a person’s memory, language and behavior.

Circadian Rhythm Disorders in Alzheimer’s Disease

Sleep disturbances usually change with the disease. However, the type of alterations and their impact depend on the subject and the stage in which the disease is located. Circadian rhythm disorders in Alzheimer’s can be divided into several types:

  • Changes in sleep architecture: These are associated with sleep stages. In people with Alzheimer’s, the stages of deep sleep are reduced. Micro-awakenings and awakenings increase. There are fewer stages of REM sleep and more non-REM sleep.
  • Breathing disorders: snoring, hypopnea and sleep apnea-hypopnea syndrome (from the English acronym OSAS). It has been possible to observe that individuals affected by the disease have a significant incidence of these diseases compared to the rest of the population. It will be necessary to study them individually, since the treatment will be specific for these pathologies and parallel to dementia.
  • Restless Legs Syndrome: In this case the person needs to perform continuous and regular movements of the legs while sleeping. This syndrome can be accompanied by nightmares.

Circadian rhythm disturbances

Alzheimer’s alters biorhythm and this condition progresses along with the disease, becoming more and more evident.

The alteration of the biorhythm leads to excessive sleepiness during the day. The person will tend to sleep throughout the day, as well as feel the need to take short naps. This exacerbates social problems due to the difficulty in maintaining conversations and relating normally.

In addition to this, daytime sleepiness and sleep will lead the individual to be less tired in the evening. This could cause him to wake up multiple times throughout the night, as well as be more nervous.

Woman with Alzheimer's and circadian rhythm disorders
People with Alzheimer’s suffer from daytime sleepiness, which means they fall asleep during the day.

Sunset syndrome in Alzheimer’s disease

A specific alteration of biorhythm is sunset or setting sun syndrome. In this case, patients with dementia begin to experience a worsening of symptoms, especially from a behavioral point of view, concomitantly with sunset. The restlessness increases and so does their restlessness.

In addition to the state of agitation and nervousness, they may suffer from hallucinations, delusions, an inexplicable fear or fits of anger. Up to 20% of dementia patients have episodes associated with this syndrome.

What can be done about it?

Although it is the best known aspect of this disease, Alzheimer’s does not manifest itself solely with memory loss. There are many symptoms that can accompany this disorder and its manifestation will be different in each patient. Those who have been diagnosed with Alzheimer’s will have to undergo the appropriate checks and communicate all the symptoms they suffer from.

In any case, the specialist will evaluate the most suitable treatment. Very often it is necessary to make several therapeutic changes until the most suitable one is found.

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