Luigi Ferini-Strambi1,2, Andrea Galbiati3, Francesca Casoni4, Maria Salsone5. 1. Department of Clinical Neurosciences, "Vita-Salute" San Raffaele University, Milan, Italy. ferinistrambi.luigi@hsr.it. 2. Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. ferinistrambi.luigi@hsr.it. 3. Department of Clinical Neurosciences, "Vita-Salute" San Raffaele University, Milan, Italy. 4. Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5. National Research Council, Institute of Molecular Bioimaging and Physiology, Catanzaro, Italy.
Abstract
PURPOSE OF THE REVIEW: There is strong evidence for a bidirectional association between sleep disorders and Alzheimer's disease (AD). In particular, insomnia may be a potentially modifiable risk factor for AD. The present review summarizes recent advances in treatment of sleep disorders in AD. RECENT FINDINGS: Some studies investigated the efficacy and safety of hypnotic agents as ramelteon and mirtazapine to treat sleep disorders in AD but no significant therapeutic effects have been observed. Benzodiazepines are the most frequently used medication for treatment of insomnia but they may cause significant side effects in old subjects. Suvorexant, an orexin receptor antagonist, showed a positive effect on AD insomnia. Recent report suggests an association between trazodone use and delayed cognitive decline in AD. With respect to circadian rhythm disorders, non-pharmacological treatments, especially bright light therapy, could be useful and safe options for treatment in AD. Some pharmacological and non-pharmacological treatments might have benefits in AD patients with sleep disturbances, but further well-designed controlled trials are needed.
PURPOSE OF THE REVIEW: There is strong evidence for a bidirectional association between sleep disorders and Alzheimer's disease (AD). In particular, insomnia may be a potentially modifiable risk factor for AD. The present review summarizes recent advances in treatment of sleep disorders in AD. RECENT FINDINGS: Some studies investigated the efficacy and safety of hypnotic agents as ramelteon and mirtazapine to treat sleep disorders in AD but no significant therapeutic effects have been observed. Benzodiazepines are the most frequently used medication for treatment of insomnia but they may cause significant side effects in old subjects. Suvorexant, an orexin receptor antagonist, showed a positive effect on ADinsomnia. Recent report suggests an association between trazodone use and delayed cognitive decline in AD. With respect to circadian rhythm disorders, non-pharmacological treatments, especially bright light therapy, could be useful and safe options for treatment in AD. Some pharmacological and non-pharmacological treatments might have benefits in ADpatients with sleep disturbances, but further well-designed controlled trials are needed.
Entities:
Keywords:
Alzheimer disease; Benzodiazepine and related drugs; Bright light therapy; Insomnia; Melatonin; Trazodone
Authors: Glenna A Dowling; Robert L Burr; Eus J W Van Someren; Erin M Hubbard; Jay S Luxenberg; Judy Mastick; Bruce A Cooper Journal: J Am Geriatr Soc Date: 2007-12-07 Impact factor: 5.562
Authors: Jee Hoon Roh; Hong Jiang; Mary Beth Finn; Floy R Stewart; Thomas E Mahan; John R Cirrito; Ashish Heda; B Joy Snider; Mingjie Li; Masashi Yanagisawa; Luis de Lecea; David M Holtzman Journal: J Exp Med Date: 2014-11-24 Impact factor: 14.307