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6:11 PM Sun, Dec. 16th

There is increasing evidence linking REM sleep problems and dementia

"It has to do with the organic problems of the disease affecting the mid-brain which control things like REM sleep, so it's a difficult problem." - Dr. Douglas Shepard, Neurology Specialty Clinic, Prescott

KINGMAN – Getting a good night’s rest may be more important than for just preventing crankiness the next day, as a new study has revealed a correlation between sleep deprivation and developing dementia.

As recently reported by CBS, the American Academy of Neurology (AAN) completed a study in which 321 individuals age 60 or older participated in the Framingham Heart Study between 1995 and 1998. Their sleep patterns were analyzed for up to 19 years, prompting the AAN to report an association between developing dementia and the lack of an adequate amount of not just sleep, but a particular kind of sleep.

“In Parkinson’s disease and dementia, up to 50 percent of patients, many of them do have REM sleep problems,” said Dr. Douglas Shepard of the Neurology Specialty Clinic in Prescott. “It has to do with the organic problems of the disease affecting the mid-brain which control things like REM sleep, so it’s a difficult problem.”

Sleep is a rather detailed nightly occurrence, as most people know, with multiple stages and varying brain functions within each stage. There are five stages of sleep, stage one being light sleep while stage two is preparation for deeper sleep, stages three and four. Stage five, commonly known as the Rapid Eye Movement (REM) stage of sleep, is the last stage and the one in which AAN found a correlation between its absence or lacking and an increased risk for dementia.

“Sleep disturbances are common in dementia but little is known about the various stages of sleep and whether they play a role in dementia risk,” said the study’s author, Matthew Pase, researcher at Swinburne University of Technology in Australia, in an AAN press release. “We set out to discover which stages of sleep may be linked to dementia and while we did not find a link with deep sleep, we did with REM sleep.”

At the end of the study, AAN found that 32 individuals of the 321 who participated developed dementia, with 24 developing Alzheimer’s disease.

“The REM sleep disturbance is pretty common in Alzheimer’s or dementia patients, or even in Parkinson’s patients,” Shepard said. “It’s certainly becoming well known.”

People often fail to note the specifics when it comes to dementia and Alzheimer’s disease. While the disease is in fact a form of dementia, having dementia does not necessarily mean one has developed Alzheimer’s. According to the Alzheimer’s Association, dementia is characterized as a loss of memory or other mental abilities that are severe enough to affect everyday life.

Forgetting a name here and there, or where one left their car keys, does not necessarily mean dementia is on the horizon. However, when memory loss and inhibited brain function begins to take a toll on everyday activities or an individual becomes incapacitated because of the loss of brain function, dementia may be entering the fold.

A lack of interest, impulsivity that’s uncharacteristic of a patient, personality changes, recent memory forgetfulness and asking the same questions repeatedly are all early signs of dementia, Shepard said.

“Generally speaking it’s a part of the older population, but not necessarily a particular age,” he added.

The study found those who developed dementia spent on average 17 percent of their sleep cycle in the REM stage, compared with 20 percent for those in which dementia did not develop.

“We worry about whether they have obstructed apneas or if they’re overweight or if they do have indeed REM sleep disorders that cause things like bad dreams or excessive daytime sleepiness,” Shepard said of being watchful for dementia.

Excessive use of certain medications such as benzodiazepines, sedatives, some psychiatric medications and alcohol can all lead to increased risk for dementia, Shepard added.

Not all medications increase the risk of dementia, and some can even help, but there lacks a definitive dementia medication.

“Medication can help, but none are ideal,” Shepard said.

Those wanting additional information on dementia can visit AAN’s patient website, http://patients.aan.com/.