为何睡眠评估应纳入记忆门诊

文献信息

中文摘要

睡眠障碍在老年人中非常普遍，在因认知障碍评估而就诊于记忆门诊的人群中尤为常见。新出现的证据将睡眠障碍（包括失眠、阻塞性睡眠呼吸暂停、昼夜节律紊乱和快速眼动睡眠行为障碍）与认知下降、神经退行性病理以及患者和照护者生活质量下降联系起来。尽管睡眠障碍患病率高且具有临床相关性，但在许多记忆门诊以及神经科、精神科和老年医学环境中并未常规评估睡眠障碍，且各医疗系统在筛查、诊断和管理方法上差异很大。本视角文章考察了四个国际背景下记忆门诊和专科环境中睡眠评估与管理的当前方法。我们强调该人群在识别和管理睡眠障碍方面缺乏系统性方法，并提出需要一个务实的阶梯式照护框架，以改善检测、指导转诊路径，并支持记忆门诊环境中更一致和个性化的照护。

英文摘要

Sleep disturbances are highly prevalent in older adults and are particularly common among individuals attending memory clinics for assessment of cognitive impairment. Emerging evidence links sleep disorders, including insomnia, obstructive sleep apnea, circadian rhythm disruption, and rapid eye movement sleep behavior disorder, to cognitive decline, neurodegenerative pathology, and reduced quality of life for patients and caregivers. Despite their high prevalence and clinical relevance, sleep disturbances are not routinely assessed within many memory clinic and neurologic, psychiatric, and geriatric settings, and approaches to screening, diagnosis, and management vary widely across health-care systems. This Perspective article examines current approaches to sleep assessment and management within memory clinic and specialized settings across four international contexts. We highlight the absence of systematic approaches to identifying and managing sleep disturbances in this population and propose the need for a pragmatic stepped-care framework to improve detection, guide referral pathways, and support more consistent and personalized care in memory clinic settings.