Abstract:
Sleep disturbances are common and clinically significant non-cognitive symptoms in Alzheimer's disease and
Lewy body dementia. Although the two conditions share partially overlapping pathology, they exhibit distinct
sleep-related profiles that can support differential diagnosis and early medical intervention. Comparison of
sleep disorders in Alzheimer’s disease and Lewy body dementia, focusing on prevalence, clinical and
neurobiological features, and treatment response for diagnosis and treatment. Comparison of sleep disorders
in Alzheimer’s disease and Lewy body dementia, focusing on prevalence, clinical and neurobiological features,
and treatment response for diagnosis and treatment. This study synthesized data from ten high-quality studies
selected from PubMed, PsycINFO, Google Scholar, and NCBI databases. The included studies consisted of
multicenter analyses, systematic reviews, and meta-analyses that assessed sleep disturbances using validated
behavioral and actigraphy-based methods in clinical and neuroimaging cohorts. REM sleep behavior disorder
and excessive daytime sleepiness are more common in Lewy body dementia (44–72%) than in Alzheimer’s
disease (15–35%), often preceding cognitive symptoms and associated with brainstem and occipital cortex
dysfunction. In Alzheimer’s disease, patients predominantly exhibit insomnia, fragmented sleep, and reduced
slow-wave sleep, linked to hippocampal atrophy. Non-pharmacological treatments, such as light therapy and
behavioral interventions, have shown greater effectiveness in Alzheimer’s disease, while melatonin and
cholinesterase inhibitors have provided benefits in Lewy body dementia. Sleep disorders differ significantly
between Alzheimer’s disease and Lewy body dementia in terms of type, severity, and treatment response.
Recognizing these specific clinical patterns may facilitate early differential diagnosis and guide personalized
therapeutic interventions.
