The Interrelationship Between Sleep Disorders and Memory Impairment: Comorbid Mechanisms and Integrated Treatment Strategies

Na Li()

Abstract

Abstract

Sleep disorders and memory impairments are prevalent in clinical practice and often coexist, significantly impacting individuals' physical, emotional, and cognitive health. The comorbidity between these conditions is multifactorial, involving neurobiological,endocrine, and metabolic factors. Structural brain changes, neuroinflammation, oxidative stress, and neurotransmitter imbalances exacerbate impairments in both sleep and memory function. This paper reviews current combination therapy strategies for managing comorbid sleep and memory disorders, analyzing the effectiveness of pharmacological treatments (such as benzodiazepines and cholinesterase inhibitors) and non-pharmacological interventions (such as Cognitive Behavioral Therapy for Insomnia (CBT-I) and cognitive training). While combination therapies show promising potential, challenges such as drug interactions and patient adherence remain. Future research should focus on exploring underlying mechanisms, developing personalized treatment approaches, and integrating novel therapeutic strategies.

Keywords

Keywords: Sleep disorders, Memory impairment, Comorbid Mechanisms, CBT-I

References

References

Adedayo AM, Olafiranye O, Smith D, Hill A, Zizi F, Brown C, Jean-Louis G. Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism. Sleep Breath. 2014 Mar;18(1):13-8. doi: 10.1007/s11325-012-0760-9.

Bin Ibrahim MZ, Benoy A, Sajikumar S. Long-term plasticity in the hippocampus: maintaining within and 'tagging' between synapses. FEBS J. 2022 Apr;289(8):2176-2201. doi: 10.1111/febs.16065.

Bonsignore MR. Obesity and Obstructive Sleep Apnea. Handb Exp Pharmacol. 2022;274:181-201. doi: 10.1007/164_2021_558.

Casagrande, M., Forte, G., Favieri, F., Corbo, I., 2022. Sleep quality and aging: a systematic review on healthy older people, mild cognitive impairment and Alzheimer’s disease. Int. J. Environ. Res. Public Health 19 (14), 8457.

Centorino MB, Bajor LA, Gootam PK, Nakase-Richardson R, Kozel FA. The Relationship of Transcranial Magnetic Stimulation With Sleep and Plasticity. J Psychiatr Pract. 2020 Nov;26(6):434-443. doi: 10.1097/PRA.0000000000000506.

Chang Wong E, Chang Chui H. Vascular Cognitive Impairment and Dementia. Continuum (Minneap Minn). 2022 Jun 1;28(3):750-780. doi: 10.1212/CON.0000000000001124.

Chung KF, Lee CT, Yeung WF, Chan MS, Chung EW, Lin WL. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Fam Pract. 2018 Jul 23;35(4):365-375. doi: 10.1093/fampra/cmx122.

Davidescu, D., Galea-Holhoș, L. B., Voiță-Mekereș, F., & Davidescu, L. (2023). Effects of Sleep Deprivation on Learning and Memory: A Review Study. Journal of Biochemical Technology, 14(4), 25–30. https://doi.org/10.51847/01ztnjmk66

de Mendonça FMR, de Mendonça GPRR, Souza LC, Galvão LP, Paiva HS, de Azevedo Marques Périco C, Torales J, Ventriglio A, Castaldelli-Maia JM, Sousa Martins Silva A. Benzodiazepines and Sleep Architecture: A Systematic Review. CNS Neurol Disord Drug Targets. 2023;22(2):172-179. doi: 10.2174/1871527320666210618103344.

Dewald-Kaufmann J, de Bruin E, Michael G. Cognitive Behavioral Therapy for Insomnia (CBT-i) in School-Aged Children and Adolescents. Sleep Med Clin. 2019 Jun;14(2):155-165. doi: 10.1016/j.jsmc.2019.02.002.

Dresp-Langley B, Hutt A. Digital Addiction and Sleep. Int J Environ Res Public Health. 2022 Jun 5;19(11):6910. doi: 10.3390/ijerph19116910.

Du L, Yang D, Wu L, Mei L, Wu S, Ba Y, Bao Y, Su R, Song L. Integration of Gut Microbiota, Serum Metabolomic, and Network Pharmacology to Reveal the Anti Insomnia Mechanism of Mongolian Medicine Sugemule-4 Decoction on Insomnia Model Rats. Drug Des Devel Ther. 2024 Jun 27;18:2617-2639. doi: 10.2147/DDDT.S455600.

El Haj M, Colombel F, Kapogiannis D, Gallouj K. False Memory in Alzheimer's Disease. Behav Neurol. 2020 Feb 19;2020:5284504. doi: 10.1155/2020/5284504.

Gossard TR, Trotti LM, Videnovic A, St Louis EK. Restless Legs Syndrome: Contemporary Diagnosis and Treatment. Neurotherapeutics. 2021 Jan;18(1):140-155. doi:10.1007/s13311-021-01019-4. Epub 2021 Apr 20.

Guan, Q., Hu, X., Ma, N., He, H., Duan, F., Li, X., Luo, Y., & Zhang, H. (2020). Sleep Quality, Depression, and Cognitive Function in Non-Demented Older Adults. Journal of Alzheimer’s Disease, 76(4), 1637–1650. https://doi.org/10.3233/JAD-190990

Hernandez, C., & Shukla, S. (2022). Liposome based drug delivery as a potential treatment option for Alzheimer’s disease. Neural Regeneration Research, 17(6), 1190. https://doi.org/10.4103/1673-5374.327328

Holbert RC, Carr BR, Bussing R. An open label pilot trial of sequential bifrontal low frequency r-TMS in the treatment of primary insomnia. Psychiatry Res. 2023 Jun;324:115194. doi: 10.1016/j.psychres.2023.115194.

Kerner NA, Roose SP. Obstructive Sleep Apnea is Linked to Depression and CognitiveImpairment: Evidence and Potential Mechanisms. Am J Geriatr Psychiatry. 2016 Jun;24(6):496-508. doi: 10.1016/j.jagp.2016.01.134. Epub 2016 Apr 29.

Kirsch DB. Obstructive Sleep Apnea. Continuum (Minneap Minn). 2020 Aug;26(4):908-928. doi: 10.1212/CON.0000000000000885.

Kweon J, Fukuda AM, Gobin AP, Haq L, Carpenter LL, Brown JC. Effect of sleep quality on repetitive transcranial magnetic stimulation outcomes in depression. Front Psychiatry. 2024 Sep 23;15:1458696. doi: 10.3389/fpsyt.2024.1458696.

Li J, Chen L, Guo F, Han X. The Effects of GABAergic System under Cerebral Ischemia: Spotlight on Cognitive Function. Neural Plast. 2020 Sep 28;2020:8856722. doi: 10.1155/2020/8856722.

Ling J, Li B, Yuan X, Yang W, Sun K. Intermittent Hypoxia Impairs Cognitive Function and Promotes Mitophagy and Lysophagy in Obstructive Sleep Apnea-Hypopnea Syndrome Rat Model. Mol Biotechnol. 2024 Nov 16. doi: 10.1007/s12033-024-01319-y.

Liu Z, Guan R, Pan L. Exploration of restless legs syndrome under the new concept: A review. Medicine (Baltimore). 2022 Dec 16;101(50):e32324. doi: 10.1097/MD.0000000000032324.

Lv R, Liu X, Zhang Y, Dong N, Wang X, He Y, Yue H, Yin Q. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduct Target Ther. 2023 May 25;8(1):218. doi: 10.1038/s41392-023-01496-3.

Mingming Z, Wenhong C, Xiaoying M, Yang J, Liu HH, Lingli S, Hongwu M, Zhirong J. Abnormal prefrontal functional network in adult obstructive sleep apnea: A resting-state fNIRS study. J Sleep Res. 2024 Apr;33(2):e14033. doi: 10.1111/jsr.14033.

Mo, W., Liu, X., Yamakawa, M., Koujiya, E., Takeya, Y., Shigenobu, K., Adachi, H., & Ikeda, M. (2024). Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Research, 339, 116067. https://doi.org/10.1016/j.psychres.2024.116067

Müller S, Mychajliw C, Reichert C, Melcher T, Leyhe T. Autobiographical Memory Performance in Alzheimer's Disease Depends on Retrieval Frequency. J Alzheimers Dis. 2016 Apr 18;52(4):1215-25. doi: 10.3233/JAD-151071.

Nogueira HA, de Castro CT, da Silva DCG, Pereira M. Melatonin for sleep disorders in people with autism: Systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2023 Apr 20;123:110695. doi: 10.1016/j.pnpbp.2022.110695.

Perlis ML, Posner D, Riemann D, Bastien CH, Teel J, Thase M. Insomnia. Lancet. 2022 Sep 24;400(10357):1047-1060. doi: 10.1016/S0140-6736(22)00879-0.

Poza JJ, Pujol M, Ortega-Albás JJ, Romero O; Insomnia Study Group of the Spanish Sleep Society (SES). Melatonin in sleep disorders. Neurologia (Engl Ed). 2022 Sep;37(7):575-585. doi: 10.1016/j.nrleng.2018.08.004.

Prabhakar NR, Peng YJ, Nanduri J. Hypoxia-inducible factors and obstructive sleep apnea. J Clin Invest. 2020 Oct 1;130(10):5042-5051. doi: 10.1172/JCI137560.

Qiu, D., Yu, Y., Li, R.-Q., Li, Y.-L., & Xiao, S.-Y. (2020). Prevalence of sleep disturbances in Chinese healthcare professionals: A systematic review and meta-analysis. Sleep Medicine, 67, 258–266. https://doi.org/10.1016/j.sleep.2019.01.047

Rana V, Ghosh S, Bhatt A, Bisht D, Joshi G, Purohit P. N-Methyl-D-Aspartate (NMDA) Receptor Antagonists and their Pharmacological Implication: A Medicinal Chemistry-oriented Perspective Outline. Curr Med Chem. 2024;31(29):4725-4744. doi: 10.2174/0109298673288031240405061759.

Reutrakul S, Van Cauter E. Sleep influences on obesity, insulin resistance, and risk of type 2 diabetes. Metabolism. 2018 Jul;84:56-66. doi: 10.1016/j.metabol.2018.02.010.

Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, Espie CA, Garcia-Borreguero D, Gjerstad M, Gonçalves M, Hertenstein E, Jansson-Fröjmark M, Jennum PJ, Leger D, Nissen C, Parrino L, Paunio T, Pevernagie D, Verbraecken J, Weeß HG, Wichniak A, Zavalko I, Arnardottir ES, Deleanu OC, Strazisar B, Zoetmulder M, Spiegelhalder K. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017 Dec;26(6):675-700. doi: 10.1111/jsr.12594.

Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, Bastien C, Berzina N, Bjorvatn B, Dikeos D, Dolenc Groselj L, Ellis JG, Garcia-Borreguero D, Geoffroy PA, Gjerstad M, Gonçalves M, Hertenstein E, Hoedlmoser K, Hion T, Holzinger B, Janku K, Jansson-Fröjmark M, Järnefelt H, Jernelöv S, Jennum PJ, Khachatryan S, Krone L, Kyle SD, Lancee J, Leger D, Lupusor A, Marques DR, Nissen C, Palagini L, Paunio T, Perogamvros L, Pevernagie D, Schabus M, Shochat T, Szentkiralyi A, Van Someren E, van Straten A, Wichniak A, Verbraecken J, Spiegelhalder K. The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. J Sleep Res. 2023 Dec;32(6):e14035. doi: 10.1111/jsr.14035.

Riemann, D., Benz, F., Dressle, R. J., Espie, C. A., Johann, A. F., Blanken, T. F., Leerssen, J., Wassing, R., Henry, A. L., Kyle, S. D., Spiegelhalder, K., & Van Someren, E. J. W. (2022). Insomnia disorder: State of the science and challenges for the future. Journal of Sleep Research, 31(4), e13604. https://doi.org/10.1111/jsr.13604

Semenza GL, Prabhakar NR. The role of hypoxia-inducible factors in carotid body (patho) physiology. J Physiol. 2018 Aug;596(15):2977-2983. doi: 10.1113/JP275696.

Shi, L., Chen, S.-J., Ma, M.-Y., Bao, Y.-P., Han, Y., Wang, Y.-M., Shi, J., Vitiello, M. V., & Lu, L. (2018). Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis. Sleep Medicine Reviews, 40, 4–16. https://doi.org/10.1016/j.smrv.2017.06.010

Shokri-Kojori E, Wang GJ, Wiers CE, Demiral SB, Guo M, Kim SW, Lindgren E, Ramirez V, Zehra A, Freeman C, Miller G, Manza P, Srivastava T, De Santi S, Tomasi D, Benveniste H, Volkow ND. β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proc Natl Acad Sci U S A. 2018 Apr 24;115(17):4483-4488. doi: 10.1073/pnas.1721694115.

Stranges, S., Tigbe, W., Gómez-Olivé, F. X., Thorogood, M., & Kandala, N.-B. (2012). Sleep Problems: An Emerging Global Epidemic? Findings From the INDEPTH WHO-SAGE Study Among More Than 40,000 Older Adults From 8 Countries Across Africa and Asia. Sleep, 35(8), 1173–1181. https://doi.org/10.5665/sleep.2012

Terzi A, Ngo KJ, Mourrain P. Phylogenetic conservation of the interdependent homeostatic relationship of sleep regulation and redox metabolism. J Comp Physiol B. 2024 Jun;194(3):241-252. doi: 10.1007/s00360-023-01530-4.

Ugalde-Muñiz P, Hernández-Luna MG, García-Velasco S, Lugo-Huitrón R, Murcia-Ramírez J, Martínez-Tapia RJ, Noriega-Navarro R, Navarro L. Activation of dopamine D2 receptors attenuates neuroinflammation and ameliorates the memory impairment induced by rapid eye movement sleep deprivation in a murine model. Front Neurosci. 2022 Oct 5;16:988167. doi: 10.3389/fnins.2022.988167.

Varinthra P, Anwar SNMN, Shih SC, Liu IY. The role of the GABAergic system on insomnia. Tzu Chi Med J. 2024 Mar 26;36(2):103-109. doi: 10.4103/tcmj.tcmj_243_23.

Wang J, Li L, Zhang Z, Zhang X, Zhu Y, Zhang C, Bi Y. Extracellular vesicles mediate the communication of adipose tissue with brain and promote cognitive impairment associated with insulin resistance. Cell Metab. 2022 Sep 6;34(9):1264-1279.e8. doi: 10.1016/j.cmet.2022.08.004.

Wang, J., Wu, J., Liu, J., Meng, Y., Li, J., Zhou, P., Xu, M., Yan, Q., Li, Q., Yin, X., & Gong, Y. (2023). Prevalence of sleep disturbances and associated factors among Chinese residents: A web-based empirical survey of 2019. Journal of Global Health, 13, 04071. https://doi.org/10.7189/jogh.13.04071

Wassing, R., Benjamins, J. S., Talamini, L. M., Schalkwijk, F., & VanSomeren, E. J. W. (2019). Overnight worsening of emotional distressindicates maladaptive sleep in insomnia. Sleep, 42(4), zsy268. https://doi.org/10.1093/sleep/zsy268

Wright A, Diebold J, Otal J, Stoneman C, Wong J, Wallace C, Duffett M. The Effect of Melatonin on Benzodiazepine Discontinuation and Sleep Quality in Adults Attempting to Discontinue Benzodiazepines: A Systematic Review and Meta-Analysis. Drugs Aging. 2015 Dec;32(12):1009-18. doi: 10.1007/s40266-015-0322-5.

Xu, W., Tan, C.-C., Zou, J.-J., Cao, X.-P., & Tan, L. (2020). Sleep problems and risk of all-cause cognitive decline or dementia: An updated systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 91(3), 236–244. https://doi.org/10.1136/jnnp-2019-321896

Yeung MK. Metamemory and executive function mediate the age-related decline in memory. J Int Neuropsychol Soc. 2024 Jun;30(5):479-488. doi: 10.1017/S1355617723011451.

Zhang H, Wang Y, Wang Y, Li X, Wang S, Wang Z. Recent advance on carbamate-based cholinesterase inhibitors as potential multifunctional agents against Alzheimer's disease. Eur J Med Chem. 2022 Oct 5;240:114606. doi: 10.1016/j.ejmech.2022.114606.

DOI: http://dx.doi.org/10.26549/jams.v7i2.22089