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MRC Prion Unit
From fundamental research to prevention and cure
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Sleeping

Many patients experience trouble with their sleeping patterns in prion disease. These problems range from sleeping all the time to not sleeping at all. The prion disease damages the thalamic areas of the brain responsible for controlling sleeping cycles. This can very often be difficult to treat. We provide advice on symptomatic management and monitor progress of this. We also provide educational sessions to carers who look after these patients. This has particular relevance to patient’s who don’t sleep, as a night duty may mean following the patient around their house or care home for a full 12 hour shift without sitting down. Therefore care providers need to consider this when placing patients or discharging them to their homes.

Patients with prion disease experience time-limited disruption of sleep (natural, periodic suspension of consciousness) amount and quality. Sleep is required to provide energy for physical and mental activities. The sleep-wake cycle is complex, consisting of different stages of consciousness: rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep, and wakefulness. As persons age the amount of time spent in REM sleep diminishes. The amount of sleep that individuals require varies with age and personal characteristics. In general the demand for sleep decreases with age. Elderly patients sleep less during the night, but may take more naps during the day to feel rested. Disruption in the individual’s usual diurnal pattern of sleep and wakefulness may be temporary or chronic. Such disruptions may result in both subjective distress and apparent impairment in functional abilities. Sleep patterns can be affected by environment, especially in hospital care units. These patients experience sleep disturbance secondary to the noisy, bright environment, and frequent monitoring and treatments. Other factors that can affect sleep patterns include temporary changes in routines such as in travelling, sharing a room with another, use of medications (especially hypnotic and anti-anxiety drugs), alcohol ingestion, night-shift rotations that change one’s circadian rhythms, acute illness, or emotional problems such as depression or anxiety. This care plan focuses on general disturbances in sleep patterns and does not address organic problems such as narcolepsy or sleep apnoea.

MRC Prion News