睡眠节律紊乱导致阿尔兹海默病相关机制的研究进展

认知功能损害患者睡眠障碍患病率高,表现形式多样,主要包括失眠、日间过度思睡、睡眠呼吸障碍、异态睡、不宁腿综合征、睡眠节律紊乱等。阿尔茨海默病(Alzheimer disease,AD)是最常见的认知损害类型。73%的中国汉族AD患者伴有睡眠障碍,其中53%伴有不同程度的睡眠节律紊乱。AD患者睡眠障碍在病程后期较为突出,因此睡眠节律紊乱一直被认为是AD相关神经退行性变的结果,如"日落现象"。但近期研究表明,睡眠节律紊乱很可能参与AD发生的始动环节。国外前瞻性随访研究发现,认知正常老年人群睡眠节律紊乱发生5年后更易发生AD。目前,关于睡眠节律紊乱通过何种途径促使神经系统退行性变发生的研究尚不深入。本文对睡眠节律紊乱引发AD相关病理、生物标志物变化进而导致AD发生的机制作一综述。

Research progress on mechanisms of sleep rhythm disturbance promoting Alzheimer disease

Patients with cognitive impairment have a high prevalence of sleep disorders with various manifestations, including insomnia, daytime hypersomnia, sleep breathing disorders, abnormal sleep, restless legs syndrome, sleep rhythm disorders, etc. Alzheimer disease (AD) is the most common type of cognitive impairment. About 73% of Chinese AD patients of Han ethnicityare associated with sleep disorders, among which 53% are related to varying degrees of sleep rhythm disorders. Sleep disorders in AD patients are more prominent in the middle and later stages, so the disturbance of sleep rhythm has always been considered as the result of AD-related neurodegenerative changes, such as "sunset phenomenon". However, recent studies have shown that disturbed sleep rhythms may be involved in the initiation of AD. Prospective follow-up studies abroad found that the cognitively normal elderly with disordered sleep rhythm was more prone to AD after 5-10 years. At present, there is still no in-depth research on how sleep rhythm disorder promotes neurodegenerative changes. This paper reviews the researches on AD-related pathology and biomarkers caused by sleep rhythm disorder.