As the connection between sleep disorders and neurodegenerative disease is strengthened, inequalities in the care of the disease become clear.
Those diagnosed with sleep disorders are more likely to develop a neurodegenerative disease within 15 years. The increased risk is independent of genetic risk for Alzheimer’s.
A new study, from scientists at the UK Dementia Research Institute (UK DRI) at Cardiff University and the US National Institutes of Health (NIH) Intramural Center for Alzheimer’s and Related Dementias, examined electronic health records from more than 1 million patients to look at the relationship between sleep and neurodegenerative diseases.
The meta-analysis found that people who had experienced certain sleep disorders were up to twice as likely to go on to develop a neurodegenerative disease in the 15 years that followed.
It also showed that sleep disorders increased the risk of Alzheimer’s and Parkinson’s, even in people with a low genetic risk of disease. This suggests that sleep disorders and genetics may influence risk separately, acting by independent mechanisms.
“Our results are compelling, indicating a clear increased risk of neurodegenerative disease following a sleep disorder, across three large biobank datasets,” said joint first author Emily Simmonds, bioinformatician at the UK DRI.
The need for scalable technologies
The research looked at data from three biobanks: the Secure Anonymised Information Linkage (SAIL) databank, UK Biobank and FinnGen. Across the three biobanks, researchers were able to obtain accurate, timestamped records of when people were experiencing sleep disorders, as marked in their medical records.
The team looked at people who had been diagnosed with one or more sleep disorders, which were grouped for data analysis into organic sleep disorders thought to be caused by physiological factors like narcolepsy, sleep apnoea and circadian rhythm sleep disorders; and non-organic sleep disorders not linked to a known physiological condition, including generalised insomnia and nightmares.
Using large-scale statistical analysis methods, the scientists mapped out the relationships between the different neurodegenerative diseases and sleep disorders.
They found that for dementia, incidences of sleep apnoea and other organic and non-organic sleep disorders were associated with an increased risk of dementia in the 10-15 years that followed. The risk was further increased for people recorded as experiencing multiple sleep disorders.
“This study adds to the growing body of evidence that sleep disorders, such as sleep apnoea, increase the risk for neurodegenerative disease. It is therefore important that we develop scalable technologies to diagnose and treat these sleep conditions early and effectively,” said Derk-Jan Dijk, group leader at the UK Dementia Research Institute Centre for Care Research & Technology at Imperial College London and the University of Surrey.
A lack of ongoing care
The research comes on the back of a new report from the Care Quality Commission (CQC), which highlights the failings of treatment for the disease. The CQC found that people do not always feel there is ongoing care for people living with dementia, that health and social care staff do not always understand the specific needs of people with dementia and there is a lack of understanding of how the care environment supports people’s wellbeing.
The CQC engaged with more than 50 stakeholders with interest and expertise in the care and treatment of people with dementia, and analysed feedback, surveys and other data to inform the report.
Inequality, the report says, is a root cause of issues facing people living with dementia. Persistent misunderstandings and stigma associated with dementia can also lead to inequalities in how care is delivered and commissioned. Inequalities are present from prevention through to people’s experience of living with the condition.
“We will use the findings from this report to develop, alongside people with lived experience, providers and other stakeholders, a definition of what good, joined-up dementia care looks like so that we can apply it to all areas of our regulatory activity,” said James Bullion, interim chief inspector of adult social care at the CQC.
