Research On The Correlation Between Sleep Disorders In Alzheimer's Disease, Parkinson's Disease And TCM Syndromes

Objective:To study the differences in sleep quality assessment,sleep disorder type and TCM syndrome distribution between patients with neurodegenerative diseases,such as Alzheimer's disease(AD)and Parkinson's disease(PD),and normal people without neurodegenerative diseases.To explore the correlation between the types of sleep disorders and the distribution of TCM syndromes in patients with neurodegenerative diseases such as AD and PD and to summarize the common TCM syndromes in AD and PD patients with sleep disorders,in order to provide new ideas for the early diagnosis of AD and PD,and for the prevention and treatment of AD and PD sleep disorders.Methods:A cross-sectional survey was conducted to collect patients from the Dongzhimen Hospital of Beijing University of Chinese Medicine and the Beijing Hospital of the Ministry of Health.A total of 169 subjects were included,aged between 42 and 90 years.There were 60 patients in the AD group,45 patients in the PD group and 64 patients in the normal control group(NC).The Pittsburgh sleep quality index(PSQI),the TCM Syndrome Element Survey Scale,the Mini-mental State Examination(MMSE),the Hamilton Anxiety Scale(HAMA),and the Hamilton Depression Scale(HAMD)were performed on the three groups.Data were evaluated using IBM SPSS software to analyze the association between sleep disorders in AD and PD patients and TCM syndromes.Results:Of the 169 subjects,77(45.56%)were male and 92(54.44%)were female.The mean age of all subjects was(66.78±10.35)years old,the maximum age was 90 years,and the minimum age was 42 years.The 169 subjects included 60 patients with AD(35.50%),45 patients with PD(26.63%),and 64 normal control subjects(37.87%).There were 84 patients(49.70%)with no sleep disorders,58 patients(34.32%)with mild sleep disorders,and 27 patients(19.58%)with severe sleep disorders.(1)Relationship between neurodegenerative diseases and sleep disorders:The differences in sleep disorders among different disease groups were compared.There were significant differences in the degree of sleep disturbance among the AD,PD and NC group(P=0.004).The degree of sleep disturbance in the AD group was significantly lower than that in the PD group(P=0.001)and the NC group(P=0.038).The differences in sleep disorder types among different disease groups were compared.The subjects in the AD group had lower difficulty in falling asleep than those in the PD group(P=0.000)and the NC group(P=0.001).The subjects in the AD group had a higher degree of daytime dysfunction than those in the PD group(P=0.008)and the NC group(P=0.000).The subjects in the AD group had higher frequency of snoring than those in the PD group(P=0.001)and the NC group(P=0.002).The subjects in the AD group had higher frequency of circadian rhythm disorder than those in the PD group(P=0.025)and the NC group(P=0.014).The subjects in the AD group had higher frequency of nocturnal sleep disturbance than those in the PD group(P=0.001)and the NC group(P=0.000).The subjects in the AD group had a higher frequency of sleep-talkiing than those in the NC group(P=0.002).The subjects in the PD group had higher frequency of nighttime lower limb twitching than those in the AD group(P=0.005)and the NC group(P=0.001).(2)Relationship between neurodegenerative diseases and TCM syndromes:The differences in TCM syndromes among different disease groups were compared.There were significant differences in the distribution of Qi deficiency syndrome(P=0.037),Yin deficiency syndrome(P=0.022),Marrow deficiency syndrome(P=0.000),Endogenous heat syndrome(P=0.004),Phlegm muddiness syndrome(P=0.000)and Liver wind syndrome(P=0.000)among AD,PD and NC group.The Phlegm muddiness syndrome score of AD group was significantly higher than that of PD group(P=0.000)and NC group(P=0.000).The Endogenous heat syndrome score of AD group was significantly higher than that of PD group(p=0.000)and NC group(P=0.000).The Yin deficiency syndrome score of PD group was significantly higher than that of AD group(P=0.000)and NC group(P=0.000).The Liver wind syndrome score of PD group was significantly higher than that of AD group(P=0.000)and NC group(P=0.000).The Blood stasis syndrome score of PD group was significantly lower than that of NC group(P=0.023).The Qi deficiency syndrome score of NC group was significantly lower than that of AD group(P=0.011)and PD group(P=0.002).The Marrow deficiency syndrome score of NC group was significantly lower than that of AD group(P=0.000)and PD group(P=0.003).(3)Relationship between sleep disorders and TCM syndromes:The differences of TCM syndromes among the three sleep disorder degree groups,which were no sleep disorder group,mild sleep disorder group and severe sleep disorder group,were compared.There were significant differences in the syndrome scores of Kidney deficiency(P=0.002),Qi deficiency(P=0.001),Blood deficiency(P=0.000),and Yin deficiency(P=0.016)among the three groups.The score of Kidney deficiency in the no sleep disorder group was significantly lower than that in the mild sleep disorder group(P=0.008)and the severe sleep disorder group(P=0.000).The score of Kidney deficiency in the mild sleep disorder group was significantly lower than that in the severe sleep disorder group(P=0.004).The score of Qi deficiency score in the no sleep disorder group was significantly lower than that in the mild sleep disorder group(P=0.002)and the severe sleep disorder group(P=0.001).The Blood deficiency score in the no sleep disorder group was significantly lower than that in the mild sleep group(P=0.000)and the severe sleep disorder group(P=0.000).The Yin deficiency score in the severe sleep disorder group was significantly higher than that in the no sleep disorder group(P=0.000)and the mild sleep disorder group(P=0.003).(4)The relationship between neurodegenerative diseases and anxiety and depression:Comparing the differences in anxiety degree among AD,PD and NC group,the anxiety degr ee of the subjects in PD group was significantly higher than that of NC group(P=0.000)and AD group(P=0.000).The anxiety degree of the subjects in AD group was significantly lower than that of the NC group(P=0.000).Comparing the differences in depression degree among AD,PD and NC group,the depression degree of the subjects in PD group was significantly higher than that of NC group(P=0.000)and AD group(P=0.000).(5)The relationship between sleep disorder and anxiety and depression:The degree of anxiety among three sleep disorder degree group was compared.The degree of sleep disorder of the non-anxiety group was significantly lower than that of the mild anxiety group(P=0.000)and the moderate anxiety group(P=0.000).The degree of depression among three sleep disorder degree group was compared.The degree of sleep disorder of the non-depression group was significantly lower than that of the mild depression group(P=0.000)and the moderate depression group(P=0.000).Conclusions:(1)Relationship between neurodegenerative diseases and sleep disorders:Subjects in AD group were more likely to fall asleep than those in PD or NC groups.But subjects in AD group were prone to SAS(sleep apnea syndrome),circadian rhythm disorder and nocturnal sleep disturbance than those in the PD or NC group.Subjects in AD group were prone to sleep-talking than those in the NC group.Subjects in the PD group were prone to RLS(restless legs syndrome)than those in the AD or NC group.(2)Relationship between neurodegenerative diseases and TCM syndromes:Subjects in the AD group were more likely to have Phlegm muddiness syndrome and Endogenous heat syndrome;subjects in the PD group were more likely to have Yin deficiency syndrome and Liver wind syndrome;patients diagnosed with neurodegenerative diseases such as AD or PD were more likely to have Qi deficiency syndrome and Marrow deficiency syndrome than those without neurodegenerative diseases.Subjects in the PD group were less likely to have Blood stasis syndrome than the normal control subjects.The common type of TCM syndrome of AD patients was presumed to be related to Phlegm muddiness and Endogenous heat;the common type of TCM syndrome of the PD group was presumed to be related to Yin deficiency and Blood deficiency.(3)Relationship between sleep disorder and TCM syndrome:Subjects with Kidney deficiency syndrome,Qi deficiency syndrome,Yin deficiency syndrome or Blood deficiency syndrome were prone to sleep disorders.(4)Relationship between neurodegenerative diseases and anxiety or depression degrees:Subjects in the PD group were more anxious and depressed than those in the NC or AD groups;subjects in the AD group were less anxious than those in the NC group.(5)Relationship between sleep disorders and anxiety or depression degrees;anxiety and depression affects sleep quality respectively.