1. Introduction
sleep disorders, neurodegenerative diseases, behavioral disorders, daytime sleepiness, decline in cognitive functions, dementia, NNG): mean ±, multiple sclerosis, Dementia
MULTIPLE SCLEROSIS, SYNDROME, NEURODEGENERATIVE DISEASES
Dementia is a progressive decline in cognitive functions caused by an alteration in the pattern of neural network connections. There is an inability to create new neuronal connections, producing behavioral disorders. The most evident alteration in patients with neurodegenerative diseases is the alteration of sleep–wake behavior. The aim of this study was to test the effect of two non-pharmacological interventions, therapeutic exercise (TE) and non-invasive neuromodulation through the NESA device (NN) on sleep quality, daytime sleepiness, and cognitive function of 30 patients diagnosed with dementia (non-invasive neuromodulation experimental group (NNG): mean ± SD, age: 71.6 ± 7.43 years; therapeutic exercise experimental group (TEG) 75.2 ± 8.63 years; control group (CG) 80.9 ± 4.53 years). The variables were evaluated by means of the Pittsburg Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Mini-Cognitive Exam Test at four different times during the study: at baseline, after 2 months (after completion of the NNG), after 5 months (after completion of the TEG), and after 7 months (after 2 months of follow-up). Participants in the NNG and TEG presented significant improvements with respect to the CG, and in addition, the NNG generated greater relevant changes in the three variables with respect to the TEG (sleep quality (Dementia is a general term to describe a clinical neurodegenerative syndrome characterized by neuronal and synaptic loss, forming a brain deposit of intra- and/or extracellular insoluble protein aggregates [A high prevalence of sleep disorders in patients with dementia has been identified for more than 30 years. Scientific evidence [Sleep is a basic biological need for the proper functioning of the organism and is essential for memory consolidation [An alteration of the circadian system has an impact on MLT secretion, and this leads to a poor synchronization of biological rhythms such as the sleep–wake cycle. In people with dementia, the suprachiasmatic nucleus (SCN) is impaired and, therefore, this leads to a reduction in melatonin production, causing a disruption of the circadian rhythms, and, therefore, in the quality of life [Currently, pharmacological options in dementia should be used with caution, seriously considering possible side effects before prescribing hypnotic and psychotropic agents [As for non-pharmacological strategies, there is currently a paucity of research in people with dementia, but even so, they are emerging as alternative procedures to improve sleep disorders in patients with dementia because of their minimal risk of side effects. These include sleep hygiene measures, light therapy, physical activity, cognitive stimulation, and auditory stimulation [The need arises for effective non-pharmacological treatments backed by scientific evidence to support their use for the cognitive function and sleep disturbances suffered by this population.In this sense, given that previous studies have shown that TE has demonstrated benefits on these characteristics, albeit in other neurodegenerative diseases [Similarly, some studies have shown positive evidence in the improvement of ANS-related dysfunctions in the field of multiple sclerosis [Therefore, the main objective of this study was to test the effect of two non-pharmacological interventions, on the one hand, therapeutic exercise (TE), and, on the other hand, non-invasive neuromodulation through the NESA device (NN), on sleep quality, daytime sleepiness, and cognitive function in patients with dementia.