A Focus on The Role of Sleep Disorders in Alzheimer’s Disease and Their Pharmacological Treatment Approaches View PDF

Yedluri Dimplesriramya
Medicine, All India Institute Of Medical Sciences, Raipur, Chhattisgarh, India
^*Rahul Akkapeddi
Medicine, Gandhi Medical College, Secunderabad, Telangana, India
Palle Esha Reddy
Medicine, Kurnool Medical College, Kurnool, Andhra Pradesh, India
Sharon Manoj Oommen
Medicine, Adichunchanagiri Institute Of Medical Sciences, B.G Nagara, Karnataka, India

^*Corresponding Author:

Rahul Akkapeddi
Medicine, Gandhi Medical College, Secunderabad, Telangana, India

Published on: 2025-06-09

Abstract

Sleep disorders are a prevalent and often debilitating symptom in Alzheimer’s disease (AD), significantly impacting cognitive function, daily activities, and quality of life (QoL). Current therapeutic options, including pharmacological treatments such as melatonin, benzodiazepines, and sedative antidepressants, offer modest improvements but are limited by side effects and variable efficacy. Non-pharmacological approaches, like cognitive-behavioral therapy and light therapy, show promise in managing sleep-wake cycle disruptions, though their effectiveness may diminish in the later stages of AD. Despite these challenges, advances in understanding the neurobiological mechanisms underlying sleep disorders in AD, such as the roles of neurotransmitters like acetylcholine, serotonin, dopamine, and orexin, have paved the way for more targeted treatment strategies. Looking forward, future treatments for sleep disorders in AD hold great potential. Precision medicine, leveraging neuroimaging and genetic insights, may allow for personalized therapeutic approaches that better address the unique needs of each patient. Additionally, novel pharmacological agents target specific neurotransmitter systems, and the combination of pharmacological and behavioral therapies offer promising solutions. Early intervention and lifestyle-based strategies may further improve patient outcomes by preventing or mitigating sleep disturbances before they significantly affect cognitive decline. With ongoing research and innovation, there is optimism that more effective, well-tolerated treatments will emerge to manage sleep disorders in AD, ultimately enhancing both patient care and QoL.

Keywords

Alzheimer’s Disease, Sleep disorders, Neurotransmitters, Pharmacological treatments, Non-pharmacological interventions

Introduction

Sleep disorders are prevalent among patients with AD and significantly impact their QoL. These disorders not only exacerbate cognitive decline but also affect the overall health and well-being of both patients and their caregivers. The most common sleep disorders associated with AD include insomnia, sleep apnea, circadian rhythm disturbances, and restless legs syndrome (Figure 1) [1]. These disorders contribute to a decline in cognitive function, increased behavioral issues, and a higher rate of institutionalization [2, 3]. Understanding these disorders and their impact is crucial for improving patient care and QoL.

Insomnia is frequently observed in AD patients and is characterized by difficulty in falling or staying asleep. It is associated with worse cognitive and functional abilities, as well as increased behavioral and neuropsychological problems [4]. Obstructive sleep apnea is prevalent in older adults and is characterized by repeated episodes of airflow cessation during sleep. It is linked to cognitive impairments, particularly in attention and memory, and shares some pathological features with AD, such as hippocampal abnormalities [5]. Circadian rhythm disturbances are common in AD and involve disruptions in the sleep-wake cycle. They can appear early in the disease course and are associated with the progression of AD [6]. Restless legs syndrome is another common disorder in AD patients, characterized by an uncontrollable urge to move their legs, often accompanied by uncomfortable sensations. It can lead to significant sleep disruption [7].

Sleep disturbances are linked to increased levels of amyloid-beta and tau proteins, which are biomarkers of AD pathology [8]. This contributes to cognitive decline and the progression of AD symptoms. Sleep disorders exacerbate behavioral and psychological symptoms in AD patients, leading to increased caregiver burden and a higher likelihood of institutionalization [9]. Poor sleep quality affects the overall health status of AD patients, reducing their QoL and that of their caregivers. It also increases the risk of other health issues, such as cardiovascular diseases [10].