الفهرس 
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Abstract
Sleep and circadian disturbances are very frequent in VaD patients and appear early in the course of the disease. The current study was conducted to assess disturbance in sleep pattern in patients with VaD, and compare it to healthy elderly individuals. The study included 20 patients of VaD with mean age 66.05 ± 2.04 and 20 healthy elderly subjects control group with mean age 65.25 ± 2.22.
The two groups were age (above 60 years old) and sex-matched. All subjects underwent a neurological, psychiatric examination, lab tests (LFTS, thyroid profile, Hb A1C) and MRI brain for each subject, the following was done; the Hachinski Ischemic Score (HIS), MMSE, CDR, GDS, The Cornell Scale for Depression, Taylor’s Manifest Anxiety Scale, psychometric sleep assessment instruments; ESS,PSQI and PSG.
In this study, comprehensive sleep disorders questionnaire revealed that the most common sleep complaints among VaD patients were; excessive daytime sleepiness (EDS) (65%), sleep disordered breathing (SDB) (50%), insomnia (15%) and RLS & PLMS (15%) and RBD (5%) respectively. OSA is a common feature of vascular dementia, and leads to fragmented sleep, increased nocturnal confusion, and excessive daytime sleepiness.
This study showed abnormal objective sleep patterns (PSG) of VaD patients. The study showed poorer sleep efficiency, prolonged sleep latency, and a tendency for more wake after sleep onset high (AI) in patients group with statistical significant difference between both groups. Moreover, patients spend more time in stage I, and have less time in SWS stage 3 and REM sleep, together with delayed REML, and less 1st REMD compared to control group. Another PSG findings like increased sleep fragmentation (more WASO & SFI), increased AI & PLMS index were also detected which is higher in VaD patients. Apart from these findings, VaD patients had significant high Apnea, Hypopnea & RDI score with high average SpO2 desaturation.
In the present study, there were no correlation as regards subjective sleep assessment; ESS & PSQI or PSG parameters; SE, SL, AI, RDI & SPO2, WASO and SFI with the stroke’s location (cortical, subcortical, frontal, thalamic, lacunar), the degree of cerebral atrophy (mild or moderate) or the type of diffuse white matter hyperintensities (WMHs).
The current study confirms that sleep is significantly impaired in patients with VaD at both the objective by PSG recordings and subjective level.