SLEEP IN NONINSTITUTIONALIZED ALZHEIMERS-DISEASE PATIENTS

The sleep of Alzheimer's disease (AD) patients is often disturbed by m edications, depression, circadian rhythm changes and sleep disorders. Institutionalization is often precipitated by the effect of the patien t's sleep and wakefulness on the caregiver. We examined reports of sle ep disturbance in mild AD patients. The study cohort consisted of 246 AD patients and 94 controls. Self-reports of sleep disturbance in mild AD patients were examined as was the relationship of sleep and medica tion use. Results were compared to those of normal controls, and the p atients' responses to the reports of their caregivers. Dementia was as sessed with the Mini Mental Status Exam, the Blessed Dementia Scale, t he Mattis Dementia Rating Scale, and the Pfeiffer Outpatient Disabilit y Test. The more demented the patients, the more time they spent in be d, the more fragmented their sleep, and the more naps they took. Careg ivers reports of increased wandering at night and more aggressive beha vior during the day were associated with increased use of sedative-hyp notics and with going to bed early. Lengthy sleep was associated with disruptive behavior. We conclude that increased sleep may be associate d with dementia and with more disruptive behavior.