Sleep disorders and risk of alzheimer's disease: A two-way road

• Published in: Ageing research reviews 2024-11, Vol.101, p.102514, Article 102514
• Main Authors: Lacerda, Rafael Antônio Vicente, Desio, Janaína Aparecida Favero, Kammers, Camila Marciele, Henkes, Silvana, Freitas de Sá, Monique, de Souza, Everton Ferreira, da Silva, Driele Martins, Teixeira Pinheiro Gusmão, Camilla, Santos, Júlio César Claudino dos
• Format: Article
• Language: English
• Subjects: Alzheimer disease; Alzheimer Disease - metabolism; Alzheimer Disease - physiopathology; Animals; Biomarkers; Homeostasis - physiology; Humans; Risk Factors; Sleep - physiology; Sleep wake disorders; Sleep Wake Disorders - complications; Sleep Wake Disorders - physiopathology
• ISSN: 1568-1637; 1872-9649; 1872-9649
• DOI: 10.1016/j.arr.2024.102514

Substantial sleep impairment in patients with Alzheimer's disease (AD) is one of the emerging points for continued efforts to better understand the disease. Individuals without cognitive decline, an important marker of the clinical phase of AD, may show early alterations in the sleep-wake cycle. The objective of this critical narrative review is to explore the bidirectional pathophysiological correlation between sleep disturbances and Alzheimer’s Disease. Specifically, it examines how the disruption of sleep homeostasis in individuals without dementia could contribute to the pathogenesis of AD, and conversely, how neurodegeneration in individuals with Alzheimer’s Disease might lead to dysregulation of the sleep-wake cycle. Recent scientific results indicate that sleep disturbances, particularly those related to impaired glymphatic clearance, may act as an important mechanism associated with the genesis of Alzheimer’s Disease. Additionally, amyloid deposition and tau protein hyperphosphorylation, along with astrocytic hyperactivation, appear to trigger changes in neurotransmission dynamics in areas related to sleep, which may explain the onset of sleep disturbances in individuals with AD. Disruption of sleep homeostasis appears to be a modifiable risk factor in Alzheimer’s disease. Whenever possible, the use of non-pharmacological strategies becomes important in this context. From a different perspective, additional research is needed to understand and treat the dysfunction of the sleep-wake cycle in individuals already affected by AD. Early recognition and correction of sleep disturbances in this population could potentially mitigate the progression of dementia and improve the quality of life for those with AD. [Display omitted] •Sleep disturbances reduce REM, impair glymphatic clearance, worsen AD inflammation.•Insomnia and daytime sleepiness are linked to beta-amyloid buildup and higher AD risk.•Biomarkers like p-tau181 predict dementia risk in Alzheimer's.•MSC-EVs show promise in Alzheimer's treatment through neurodegeneration.•Early sleep treatment may enhance clearance of beta-amyloid, slowing Alzheimer's.