Sleep-disordered breathing and agitation in institutionalized adults with Alzheimer disease

Objective: The authors examined the relationship between sleep-disordered breathing (SDB) and agitation in patients with Alzheimer disease (AD). Methods: Thirty-eight AD patients (29 women, 9 men) in nursing homes in San Diego, CA participated. The mean age was 82.3 years, with a range of 61 to 95 years. Mean Mini-Mental State Exam score was 65 (range: 0-16). Sleep was recorded for one night, and agitation was measured with behavioral observations and ratings by nursing staff. Results: SDB was very prevalent in this sample and was related to some types of agitation during the day but not in the evening or night. Aggressive Agitation on the Cohen-Mansfield Agitation Inventory and Manual Manipulation on the Agitated Behavior Rating Scale were greater with more severe SDB. Searching and wandering agitation decreased with more severe SDB. Conclusion: This study supports the hypothesis that SDB is related to agitation in AD, although the results arc, specific to certain types of agitation. Treatment of SDB may decrease agitation, easing the burden of caregiving and prolonging the time that patients art, able to remain at home.