The past, present, and future of sleep measurement in mild cognitive impairment and early dementia—towards a core outcome set: a scoping review

Sleep

article

Blackman, Jonathan¹  Morrison, Hamish Duncan¹  Lloyd, Katherine¹  Gimson, Amy²  Banerjee, Luke Vikram²  Green, Sebastian¹  Cousins, Rebecca²  Rudd, Sarah³  Harding, Sam⁴  Coulthard, Elizabeth¹ 

[1] Bristol Medical School, University of Bristol;Bristol Brain Centre;Library and Knowledge Service;Research and Innovation

关键词: sleep;    Alzheimer’s disease;    mild cognitive impairment;    MCI;    AD;   

DOI  :  10.1093/sleep/zsac077

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment.Methods This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure.Results Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters.Conclusions Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.

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