Characteristics of sleep disturbance in community-dwelling Alzheimer's disease patients

This study examined the frequency, predictors, and impact of sleep problems in a population-based sample of 205 Alzheimer's disease (AD) patients. Sle eping more than usual and early morning awakenings were the most common sle ep problems reported but were the least disturbing behaviors for caregivers . Night-time awakenings were less common but were most disturbing to caregi vers. Using logistic regression analyses, the factors most strongly associa ted with night awakenings among patients were male gender, greater memory p roblems, and decreased functional status. Patient depression increased the risk for caregivers to rate patient sleep problems as more disturbing overa ll. Cluster analyses revealed three characteristic groups of patients who a wakened caregivers: one group was inactive during the day but had few other behavior problems; one group had increased levels of fearfulness, fidgetin g, and occasional sadness; and the third group had multiple behavior proble ms, including frequent episodes of sadness, fearfulness, inactivity, fidget ing, and hallucinations. These findings indicate that the nature of sleep p roblems in AD is multifaceted; future research on the occurrence and treatm ent of sleep disturbance in dementia patients should consider the patterns of individual differences that may influence its development.