Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia

Background: Sleep disturbances and disruption of the neural regulation of the sleep-wake rhythm appear to be involved in the cellular and molecular mechanisms of cognitive decline. Although sleep problems are highly prevalent in mild cognitive impairment (MCI) and many types of dementia, they have not been systematically investigated in the clinical setting and are often only investigated by sleep specialists upon individual request. Summary: This review discusses sleep disorders in the context of cognitive decline and provides an overview of the clinical diagnosis and management of these disorders in patients with dementia and MCI. Key Messages: Sleep disorders are largely underestimated and do not receive sufficient attention in the global management of dementia patients. Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression. They are positively associated with the severity of behavioral problems and cognitive imReceived: October 3, 2014 Accepted: May 26, 2015 Published online: July 4, 2015 Dr. Biancamaria Guarnieri Center of Sleep Medicine, Villa Serena Hospital Viale L. Petruzzi 42 IT–65013 Città S. Angelo, Pescara (Italy) E-Mail bmariaguarnieri @ villaserena.it © 2015 S. Karger AG, Basel 0014–3022/15/0742–0043$39.50/0