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Pharmacological and non-pharmacological treatment options for sleep disturbances in Alzheimer's disease.

Expert review of neurotherapeutics
June 1, 2023
Binish Javed et al. (4 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness and safety of melatonin as an adjunctive therapy for sleep disturbances in Alzheimer's disease patients.

Results Summary

Melatonin was found to be a commonly used adjunctive therapy for sleep disturbances in AD patients, with non-pharmacological interventions preferred first-line. The study suggests melatonin is effective but does not provide detailed efficacy metrics.

Population

Older patients with Alzheimer's disease experiencing sleep disturbances.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Non-pharmacological interventions
increase
sleep-related symptoms
AD patients
-
are generally preferred as the first-line approach to improve
#1
Trazodone
increase
sleep disturbances
AD patients
-
are commonly used as adjunctive therapies
#2
melatonin
increase
sleep disturbances
AD patients
-
are commonly used as adjunctive therapies
#3
Z-drugs including zopiclone and zolpidem
decrease
insomnia
patients with late-onset AD
-
are specifically employed to treat
#4
dual orexin receptor antagonists
increase
sleep onset and maintenance
AD patients
-
gained approval for improving
#5
Abstract

INTRODUCTION: Alzheimer's disease (AD) is one of the most common neurodegenerative disorders among the older population. Sleep disruption and circadian rhythm disorders often develop in AD patients, and many experience sleeping difficulties requiring pharmacological and non-pharmacological interventions. AREAS COVERED: This review appraised the evidence from clinical studies on various pharmacological and non-pharmacological therapies for sleep disturbances in AD patients and proposed an algorithm to manage sleep disturbances in this population of patients. EXPERT OPINION: Non-pharmacological interventions are generally preferred as the first-line approach to improve sleep-related symptoms in AD due to their favorable safety profile. However, when non-pharmacological interventions alone are insufficient, a range of pharmacological agents can be considered. Trazodone and melatonin are commonly used as adjunctive therapies, while Z-drugs including zopiclone and zolpidem are specifically employed to treat insomnia in patients with late-onset AD. Furthermore, a newer class of agents known as dual orexin receptor antagonists has emerged and gained approval for improving sleep onset and maintenance in AD patients.

Medical Subject Headings (MeSH)
HumansAlzheimer DiseaseSleepSleep Wake Disorders
Study Links
Quality Scores
Safety80
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations9
Citations/Year4.5
Relative Citation Ratio2.31
NIH Percentile78.7%
Research Impact Scores
APT Score0.75
Weight Score2.91
Normalized Score0.79
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