Assessment of Sleep Pattern in Egyptian Elderly Subjects with Vascular Dementia: An Egyptian Study on Elderly Population

Abstract

Background: Sleep is considered to be very important for cognitive function and also cognitive deficits and sleep disorders are influenced by one another. Currently, growing evidence suggests that sleep disturbances is common in vascular dementia (VaD).
Study Objectives: The goal of the current study was to assess the disturbance in sleep pattern in patients with vascular dementia(VaD) and compare it to healthy normally cognitive elderly individuals. The study further investigated whether meaningful differences in the Subjective sleep assessment (ESS and PSQI) and sleep measurements (PSG) in VaD patients.
Study Design/Method: Overnight PSG recordings and self-reported sleep measures were obtained from 20 healthy elderly subjects and 20 VaD patients at the sleep laboratory.
Results: This study showed abnormal subjective sleep quality in all patients and revealed that the most common sleep complaintsamong VaD patients were excessive daytime sleepiness (EDS), sleep disordered breathing (SDB), insomnia and RLS and PLMS and REM behavioral disordered, respectively. Moreover, patients spent more time in stage I sleep, but less time in SWS and REM sleep compared to control populations, with delayed REML and less 1st REML. In addition, increased sleep fragmentation (WASO and SFI) and increased AI and PLMS index were detected in VaD patients. Finally, VaD patients had significantly (p < 0.05) high apnea, hypopnea and RDI score with high average SpO2 desaturation.
Conclusions: It is conclude that sleep is significantly (p < 0.05) impaired in patients with VaD at both the objective and subjective levels which may be used as a diagnostic marker of VaD. SBD is a common feature of VaD leading to fragmented sleep, increased nocturnal confusion and excessive daytime sleepiness. Subjective sleep assessment questionnaire by (ESS and PSQI) can be used in VaD patients when objective sleep assessment by PSG recordings is difficult to be done. The PSG study of sleep continuity, sleep architecture and REM sleep may help in the prevention of progression of VaD.