Chronotherapeutika bei neurodegenerativen Erkrankungen
Dieter Kunz,
AG Schlafforschung & Klinische Chronobiologie,
Deutsches Herzzentrum Berlin & Charité - Universitätsmedizin,
Berlin
Nighttime agitation is frequent in patients suffering from neurodegenerative
disorders such as Alzheimer disaese and / or synucleinopathy. In Alzheimer
nighttime disturbances are thought to be circadian rhythm disturbances. These
disturbances cause exhaustion in the caregivers because of poor sleep. Exhaustion
is considered the number one reason for longterm institutionalization of these
patients. REM-sleep behavior disorder is considered a precursor of synucleinopathies.
Here the outacting of dreams often cause injuries to the patients or the partners
sleeping nearby.
The two chronotherapeutics light and melatonin - as the signal of darkness
- show beneficial effects in neurodegenerative disorders. Both lack serious
side effects. Still,especially with respect to light in demented patients reports
are inconsistent. One of the major reasons is the emerging picture of complexity
with many interrelations on the effects of light on human health. Since the
discovery of melanopsin and description of his melatonin action spectrum some
ten years ago, a tremendous amount of new data on the topic has been reported.
It is clear that light has a pivotal influence on human performance, well-being
and health. Melatonin has positive effects in both nighttime agitation in Alzheimer´s
as well as in RBD patients.