A good night's sleep is essential for everyone. In individuals with Huntington's disease (HD), sleep disturbances constitute an additional burden that may exacerbate disease outcomes and impact patients' quality of life. In a special issue of the Journal of Huntington's Disease , researchers review what is, and perhaps more importantly, what is not known about sleep and circadian rhythms in HD.
Jenny Morton, Ph.D., ScD, professor of neurobiology, University of Cambridge, says,"Good quality sleep and healthy diurnal rhythms are fundamental to human health and wellness, although for the most part we greatly underappreciate the role they play in our lives. It is only when they become disordered that we pay attention.
"Sleep dysfunction in normal people is taken seriously, and it is recognized that it exacerbates a range of cognitive symptoms, including deficits in executive function, memory consolidation, attention, and processing speed, as well as affective features such as impulsivity and emotional liability. Notably, most if not all these symptoms are present in HD at some stage in the course of the disease, yet the impact of sleep dysfunction on HD patient symptoms is rarely considered.
"Treatment of sleep and circadian disturbances in HD represents a big unmet need in HD. Well-designed intervention studies aimed at the treatment of poor sleep associated with HD are very much needed. Noninvasive and low cost circadian-based therapies such as light therapy may be promising for the management of sleep-wake disturbances in HD," concludes Dr. Videnovic.
Sleep disruption may not only exacerbate cognitive and affective symptoms, but also directly affect neurodegenerative processes by inducing neuroinflammation or impairing slow wave sleep-dependent glymphatic clearance of neurotoxic waste. If sleep deprivation is associated with an increase in neurotoxic proteins such as b-amyloid and tau, known contributors to neurodegeneration in Alzheimer's disease, it may also affect the HD brain.
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