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Therapy for Insomnia and Circadian Rhythm Disorder in Alzheimer Disease

  • Sleep Disorders (A Iranzo, Section Editor)
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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.

Summary

Some pharmacological and non-pharmacological treatments might have benefits in AD patients with sleep disturbances, but further well-designed controlled trials are needed.

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Authors and Affiliations

  1. Department of Clinical Neurosciences, “Vita-Salute” San Raffaele University, Milan, Italy

    Luigi Ferini-Strambi MD & Andrea Galbiati PhD

  2. Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Luigi Ferini-Strambi MD & Francesca Casoni MD

  3. National Research Council, Institute of Molecular Bioimaging and Physiology, Catanzaro, Italy

    Maria Salsone MD

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Correspondence to Luigi Ferini-Strambi MD.

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Dr. Andrea Galbiati declares that she has no conflict of interest. Dr. Francesca Casoni declares that she has no conflict of interest. Dr. Maria Salsone declares that she has no conflict of interest. Dr. Luigi Ferini-Strambi reports personal fees from UCB Pharma, personal fees from Lundbeck, personal fees from Pfizer, personal fees from Italfarmaco, personal fees from Valeas, personal fees from Angelini, personal fees from Eisai, and personal fees from Philips Respironics outside the submitted work.

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Ferini-Strambi, L., Galbiati, A., Casoni, F. et al. Therapy for Insomnia and Circadian Rhythm Disorder in Alzheimer Disease. Curr Treat Options Neurol 22, 4 (2020). https://doi.org/10.1007/s11940-020-0612-z

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  • DOI: https://doi.org/10.1007/s11940-020-0612-z

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