Suboptimal sleep causes cognitive decline and probably accelerates Alzheimer s Disease (AD) progression. Several sleep interventions have been tested in established AD dementia cases. However early intervention is needed in the course of AD at Mild Cognitive Impairment (MCI) or mild dementia stages to help prevent decline and maintain good quality of life. This systematic review aims to summarize evidence on sleep interventions in MCI and mild AD dementia. Seven databases were systematically searched for interventional studies where greater than 75% of participants met diagnostic criteria for MCI/mild AD dementia, with a control group and validated sleep outcome measures. Studies with a majority of participants diagnosed with Moderate to Severe AD were excluded. 20164 references were returned after duplication removal. 284 full papers were reviewed with 12 retained. Included papers reported 11 separate studies, total sample (n=602), mean age 76.3 years. Nine interventions were represented: Cognitive Behavioural Therapy Insomnia (CBT I), A Multi-Component Group Based Therapy, Phase Locked Loop Acoustic Stimulation, Melatonin, Donepezil, Galantamine, Rivastigmine, Tetrahydroaminoacridine and Continuous Positive Airway Pressure (CPAP). Psychotherapeutic approaches utilising adapted CBT-I achieved statistically significant improvements in the Pittsburgh Sleep Quality Index with one study reporting co-existent improved actigraphy variables. Melatonin significantly reduced sleep latency and sleep to wakefulness transitions in a small sample. CPAP demonstrated efficacy in participants with Obstructive Sleep Apnoea. Evidence to support other interventions was limited. There is a paucity of evidence for sleep interventions in MCI and mild AD highlighting a pressing need for high quality experimental studies exploring alternative sleep interventions.

中文翻译：

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药物和非药物干预措施可增强轻度认知障碍和轻度阿尔茨海默氏病的睡眠：系统评价

睡眠不足会导致认知能力下降，并可能加速阿尔茨海默氏病（AD）的进展。在确定的AD痴呆病例中已经测试了几种睡眠干预措施。但是，在AD的轻度认知障碍（MCI）或轻度痴呆阶段中需要早期干预，以帮助预防衰老和维持良好的生活质量。本系统综述旨在总结有关MCI和轻度AD痴呆的睡眠干预的证据。系统地搜索了七个数据库以进行干预研究，其中超过75％的参与者符合MCI /轻度AD痴呆的诊断标准，并具有对照组和经过验证的睡眠结果指标。排除了大多数被诊断为中度至重度AD的参与者的研究。删除重复项后返回20164参考。审查了284篇全文，保留12篇。纳入的论文报道了11项单独的研究，总样本（n = 602），平均年龄76.3岁。代表了九种干预措施：认知行为疗法失眠症（CBT I），基于多成分组的疗法，锁相环声刺激，褪黑素，多奈哌齐，加兰他敏，利伐斯的明，四氢氨基ac啶和持续气道正压通气（CPAP）。使用适应性CBT-I的心理治疗方法在匹兹堡睡眠质量指数上实现了统计学上的显着改善，一项研究报告了同时存在的改进的书法字法变量。在一个小样本中，褪黑激素显着​​减少了睡眠潜伏期和从睡眠到觉醒的转变。CPAP在阻塞性睡眠呼吸暂停参与者中显示出疗效。支持其他干预措施的证据有限。