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Volume 8 Journal of Alzheimers Disease & Parkinsonism
ISSN: 2161-0460 Euro Dementia 2018
May 24-25, 2018
May 24-25, 2018 | Vienna, Austria
11th International Conference on
Alzheimers Disease & Dementia
Time to wake up to sleep disorders in dementia
Santosh Bangar1, 2 and Abhishek Shastri3
1Global Hospitals, Mumbai, India
2MIND Clinic for Senior Citizens, India
3Central and North West London NHS Foundation Trust, UK
In the last few years, there has been an increase in the studies of sleep disorders and their role in the pathogenesis of dementia.
Most notably, obstructive sleep apnoea (OSA) and rapid eye movement (REM) sleep behaviour disorder have been closely
studied. We carried out a narrative review of OSA to study its association with Alzheimer’s disease and mild cognitive
impairment (MCI). OSA is a very common, yet undiagnosed sleep disorder, with high prevalence in older people. OSA is
characterized by repetitive cessation or reduction of airflow due to upper airway obstruction. It is a well-known risk factor for
vascular illnesses and has been implicated in the pathogenesis of stroke, hypertension and cardiac arrhythmias. The resultant
chronic intermittent hypoxia and hypercapnia in undiagnosed OSA can result in cognitive impairment. Furthermore, OSA
with cognitive impairment shares some features with Alzheimer's disease, such as involving genetic predisposition ApoE4,
hippocampus and synaptic plasticity abnormalities. On balance, OSA has negative effects on cognition, most likely in the
domain of attention, verbal and visual delayed long-term memory and executive functions. A still unanswered question
is whether these deficits are primarily a consequence of sleep fragmentation and/or hypoxemia, or whether they co-exist
independently from OSA. A thorough clinical examination with an emphasis on a comprehensive sleep history is cornerstone
in the assessment of OSA. However, sleep study is required to make a definitive diagnosis. First line of treatment includes
modification of lifestyle, for e.g., reduction of body weight, quitting smoking and alcohol use. The gold standard treatment is
continuous positive airway pressure (CPAP); however, tolerability can be an issue, especially in older people diagnosed with
dementia. Another important sleep problem important in neurodegenerative illnesses is REM sleep behaviour disorder (RBD),
classed as a parasomnia. It has well established links with synucleinopathies, such as Parkinson's disease, Lewy body dementia
(LBD) or multiple system atrophy. However, RBD can occur in patients with Alzheimer’s disease, a non-synucleinopathy.
Recent Publications
1. Santosh Bangar, Abhishek Shastri, Hany El-Sayeh, and Andrea E Cavanna (2016) Women with epilepsy: clinically
relevant issues. Functional Neurology 31(3):127–134.
2. Mehboob Yaqub, Yasir Akbar and Santosh Bangar (2016) Tourette’s syndrome: Is there a causal link to violence?
International Journal of Endorsing Health Science Research 4(1):7–14.
3. Abhishek Shastri, Santosh Bangar and John Holmes (2016) Obstructive sleep apnoea and dementia–is there a link?
International Journal of Geriatric Psychiatry 31(4):400–5.
Biograpy
Santosh Bangar was trained in the UK to achieve a CCT in Geriatric Psychiatry with an Endorsement in Liaison Psychiatry of Older People. To pursue his interest in
Neuropsychiatry, he studied at the University of Birmingham and achieved a merit. He practises as a Consultant Geriatric Neuropsychiatrist with special interest in
Sleep Disorders. He has published articles in Obstructive Sleep Apnoea, Epilepsy, Tourette’s syndrome and Delirium. He has been invited to international and national
conferences and has served as a Peer Reviewer for prominent scientific journals.
Santosh Bangar et al., J Alzheimers Dis Parkinsonism 2018, Volume 8
DOI:10.4172/2161-0460-C3-042