Sleep and Wakefulness Disorders in Vascular Cognitive Impairment

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Dementia is a pathology that leads to disability and significantly affects the quality of life of patients and their relatives. The study and development of treatment methods for dementia is a priority in medicine, given the rate of growth in the number of patients. Vascular dementia is the second most common type of dementia in the world after Alzheimer disease. Poor sleep quality is a common feature of the neuropsychiatric profile in dementia patients. Sleep disorders are a modifiable and significant risk factor for cardiovascular disorders, in particular, vascular cognitive impairment. Several sleep disorders are more pronounced in patients with vascular dementia than in patients with dementia due to Alzheimer disease.

This review contains data on changes in the sleep-wake cycle, often found in vascular cognitive impairments. The likely mechanisms connecting sleep disorders and vascular cognitive impairments are described. The possibility of predicting the development of vascular cognitive impairment based on identified sleep disorders is shown, as well as the potential for studying and developing methods to treat sleep disturbances to prevent vascular cognitive impairment are presented.

About the authors

Tatyana B. Merkulova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Russian Federation, Moscow

Gennadiy V. Kovrov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Nikolay N. Yakhno

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow


  1. Global action plan on the public health response to dementia 2017–2025. Geneva: World Health Organization; 2017. 52 p
  2. Rizzi L., Rosset I., Roriz-Cruz M. Global epidemiology of dementia: Alzheimer ’ s and vascular types. Biomed Res Int 2014; 2014:908915. doi: 10.1155/2014/908915. PMID: 25089278
  3. Poluektov M., Preobrazhenskaya I. [Sleep and cognitive dysfunctions. Therapeutic approach]. Nevrologiya, neyropsikhiatriya, psikhosomatika 2014; 6(1): 68–73. doi: 10.14412/2074-2711-2014-1-68-73. (In Russ.)
  4. Isaev R.I., Yakhno N.N. [Sleep disorders in Alzheimer’s disease]. Nevrologicheskiy Zhurnal 2017; 22(5): 228–236. doi: 10.18821/1560-9545-2017-22-5-228-236. (In Russ.)
  5. do Vale F.A.C., Guarnieri R., Liboni M. et al. Reports by caregivers of behavioral and psychological symptoms of dementia. Dement Neuropsychol 2007; 1(1): 97–103. doi: 10.1590/S1980-57642008DN10100015. PMID: 29213374.
  6. Harris Y., Gorelick P.B., Cohen D. et al. Psychiatric symptoms in dementia associated with stroke: a case-control analysis among predominantly African-American patients. J Natl Med Assoc 1994; 86: 697–702. PMID: 7966434.
  7. Bandyopadhyay T.K., Biswas A., Roy A. et al. Neuropsychiatric profiles in patients with Alzheimer's disease and vascular dementia. Ann Indian Acad Neurol 2014; 17: 325–330. doi: 10.4103/0972-2327.138520. PMID: 25221405.
  8. Cipriani G., Lucetti C., Danti S., Nuti A. Sleep disturbances and dementia. Psychogeriatrics 2014; 15: 65–74. doi: 10.1111/psyg.12069. PMID: 25515641.
  9. Mooe T., Rabben T., Wiklund U. et al. Sleep-disordered breathing in men with coronary artery disease. Chest 1996; 109: 659–663. doi: 10.1378/chest.109.3.659. PMID: 8617073.
  10. Xie C., Zhu R., Tian Y., Wang K. Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis. BMJ Open 2017; 7: e013983. doi: 10.1136/bmjopen-2016-013983. PMID: 29275335.
  11. Mohsenin V. Obstructive sleep apnea and hypertension: a critical review. Curr Hypertens Rep 2014; 16: 482. doi: 10.1007/s11906-014-0482-4. PMID: 25139780.
  12. Tazartukova A.D., Stakhovskaya L.V. [Long-term outcome prediction in patients with stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118: 37–41. doi: 10.17116/jnevro201811809237. (In Russ.)
  13. Lutokhin G.M., Geraskina L.A., Fonyakin A.V., Maksimova M.Yu. [Optimization of early rehabilitation of patients with ischemic stroke and sleep-disordered breathing]. Annals of Clinical and Experimental Neurology 2017; 10(2): 5–13. doi: 10.18454/ACEN.2017.2. (In Russ.)
  14. Jackson M.L., Howard M.E., Barnes M. Cognition and daytime functioning in sleep-related breathing disorders. Prog Brain Res 2011; 190: 53–68. doi: 10.1016/b978-0-444-53817-8.00003-7. PMID: 21531244.
  15. Bucks R.S., Olaithe M., Eastwood P. Neurocognitive function in obstructive sleep apnoea: A meta-review. Respirology 2011; 18: 61–70. doi: 10.1111/j.1440-1843.2012.02255.x. PMID: 22913604.
  16. Kim H., Yun C.-H., Thomas R. J. et al. Obstructive sleep apnea as a risk factor for cerebral white matter change in a middle-aged and older general population. SLEEP 2013; 36: 709–715. doi: 10.5665/sleep.2632. PMID: 23633753.
  17. Incalzi R.A., Marra C., Salvigni B.L. et al. Does cognitive dysfunction conform to a distinctive pattern in obstructive sleep apnea syndrome? J Sleep Res 2014; 13: 79–86. doi: 10.1111/j.1365-2869.2004.00389.x. PMID: 14996039.
  18. Matthews E.E., Aloia M.S. Cognitive recovery following positive airway pressure (PAP) in sleep apnea. Prog Brain Res 2011; 190: 71–88. doi: 10.1016/B978-0-444-53817-8.00004-9. PMID: 21531245.
  19. Elwood P.C., Bayer A.J., Fish M. et al. Sleep disturbance and daytime sleepiness predict vascular dementia. J Epidemiol Community Health 2010; 65: 820–824. doi: 10.1136/jech.2009.100503. PMID: 20675705.
  20. Blachier M., Dauvilliers Y., Jaussent et al. Excessive daytime sleepiness and vascular events: the three city study. Ann Neurol 2013: 71: 661–667. doi: 10.1002/ana.22656. PMID: 22271307.
  21. Lo J.C., Groeger J.A., Cheng G.H. et al. Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Med 2016; 17: 87–98. doi: 10.1016/j.sleep.2015.08.021. PMID: 26847980.
  22. Hayes T.L., Riley T., Mattek N. et al. Sleep habits in mild cognitive impairment. Alzheimer Dis Assoc Disord 2014; 28: 145–150. doi: 10.1097/wad.0000000000000010. PMID: 24145694.
  23. Zhu M.F., Deng L.Y., Gong L.M. et al. Macrostructure of sleep in patients with vascular cognitive impairment-no dementia. Nan Fang Yi Ke Da Xue Xue Bao 2011; 31: 295–298. PMID: 21354915.
  24. Tsuno N., Shigeta M., Hyoki K. et al. Fluctuations of source locations of EEG activity during transition from alertness to sleep in Alzheimer’s disease and vascular dementia. Neuropsychobiology 2004; 50: 267–272. doi: 10.1159/000079982. PMID: 15365227.
  25. Jiang B., Ding C., Yao G. et al. Polysomnographic abnormalities in patients with vascular cognitive impairment-no dementia. Sleep Med 2013; 14: 1071–1075. doi: 10.1016/j.sleep.2013.07.003. PMID: 24051120.
  26. Walters A.S., Rye D.B. Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 2009; 32: 589–597. doi: 10.1093/sleep/32.5.589. PMID: 19480225.
  27. Bekci T.T., Kayrak M., Kiyici A. et al. The relation between Lp-PLA2 levels with periodic limb movements. Sleep Breath 2012; 16: 117–122. doi: 10.1007/s11325-010-0464-y. PMID: 21221825.
  28. Chappell D.C., Varner S.E., Nerem R.M. et al. Oscillatory shear stress stimulates adhesion molecule expression in cultured human endothelium. Circ Res 1998; 82: 532–539. doi: 10.1161/01.res.82.5.532. PMID: 9529157.
  29. Boulos M.I., Murray B.J., Muir R.T. et al. Periodic limb movements and white matter hyperintensities in first-ever minor stroke or high-risk transient ischemic attack. Sleep 2016; 40: zsw080. doi: 10.1093/sleep/zsw080. PMID: 28329254.
  30. Zhong G., Naismith S.L., Rogers N.L., Lewis S.J.G. Sleep-wake disturbances in common neurodegenerative diseases: a closer look at selected aspects of the neural circuitry. J Neurol Sci 2011; 307: 9–14. doi: 10.1016/j.jns.2011.04.020. PMID: 21570695.
  31. Zhang J., Zhu Y., Zhan G. et al. Extended wakefulness: compromised metabolics in and degeneration of locus ceruleus neurons. J Neurosci 2014; 34: 4418–4431. doi: 10.1523/jneurosci.5025-12.2014. PMID: 24647961.
  32. Rey N. L., Jardanhazi-Kurutz D., Terwel D. et al. Locus coeruleus degeneration exacerbates olfactory deficits in APP/PS1 transgenic mice. Neurobiol Aging 2012; 33; 426.e1–426.e11. doi: 10.1016/j.neurobiolaging.2010.10.009. PMID: 21109328.
  33. Sterniczuk R., Dyck R.H., LaFerla F.M., Antle M.C. Characterization of the 3xTg-AD mouse model of Alzheimer’s disease: Part 1. Circadian changes. Brain Res 2010; 1348: 139–148. doi: 10.1016/j.brainres.2010.05.013. PMID: 20471965.
  34. Kroeger D., Ferrari L.L., Petit G. et al. Cholinergic, glutamatergic, and GABAergic neurons of the pedunculopontine tegmental nucleus have distinct effects on sleep/wake behavior in mice. J Neurosci 2017; 37: 1352–1366. doi: 10.1523/jneurosci.1405-16.2016. PMID: 28039375.
  35. Wisor J.P., Edgar D.M., Yesavage J. et al. Sleep and circadian abnormalities in a transgenic mouse model of Alzheimer’s disease: A role for cholinergic transmission. Neuroscience 2005; 131: 375–385. doi: 10.1016/j.neuroscience.2004.11.018. PMID: 15708480.
  36. Javaheri S., Redline S. Insomnia and risk of cardiovascular disease. Chest 2017; 152: 435–444. doi: 10.1016/j.chest.2017.01.026. PMID: 28153671.
  37. Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr 2006; 83: 456S–460S. doi: 10.1093/ajcn/83.2.456s. PMID: 16470012.
  38. Shearer W.T., Reuben J.M., Mullington J.M. et al. Soluble TNF-α receptor 1 and IL-6 plasma levels in humans subjected to the sleep deprivation model of spaceflight. J Allergy Clin Immunol 2001; 107: 165–170. doi: 10.1067/mai.2001.112270. PMID: 11150007.
  39. Sauvet F., Drogou C., Bougard C. et al. Vascular response to 1week of sleep restriction in healthy subjects. A metabolic response? Int J Cardiol 2015; 190: 246–255. doi: 10.1016/j.ijcard.2015.04.119. PMID: 25932797.
  40. Münzel T., Camici G.G., Maack C. et al. Impact of oxidative stress on the heart and vasculature. J Am Coll Cardiol 2017; 70: 212–229. doi: 10.1016/j.jacc.2017.05.035. PMID: 28683969.
  41. Duffy S.L., Lagopoulos J., Terpening Z. et al. Association of anterior cingulate glutathione with sleep apnea in older adults at-risk for dementia. Sleep 2016; 39: 899–906. doi: 10.5665/sleep.5650. PMID: 26856906.
  42. Nikolenko V.N., Oganesyan M.V., Yakhno N.N. et al. [The brain’s glymphatic system: physiological anatomy and clinical perspectives]. Nevrologiya, neyropsikhiatriya, psikhosomatika 2018; 10(4): 94–100. doi: 10.14412/2074-2711-2018-4-94-100. (In Russ.)
  43. Jessen N.A., Munk A.S.F., Lundgaard I., Nedergaard M. The glymphatic system: a beginner’s guide. Neurochem Res 2015; 40: 2583–2599. doi: 10.1007/s11064-015-1581-6. PMID: 25947369.
  44. Beaulieu-Bonneau S., Hudon C. Sleep disturbances in older adults with mild cognitive impairment. Int Psychogeriatr 2009; 21: 654–666. doi: 10.1017/s1041610209009120. PMID: 19426575.

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Copyright (c) 2020 Merkulova T.B., Kovrov G.V., Yakhno N.N.

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