Treatment of sleep disturbance in Alzheimer's dementia

Objective To review the evidence-base behind current treatment options for sleep disturbance in Alzheimer's dementia. Design A systematic review synthesized the qualitative and quantitative evidence on the treatment of sleep disturbance in Alzheimer's dementia. Studies with interventions targeting sleep disturbance in Alzheimer's dementia or other aspects of the neuropsychiatric symptoms, but which reported an effect on sleep, were included. The Oxford Center for Evidence-Based Medicine criteria was used in the evaluation and scoring of each study based on the quality of the evidence. Results Thirty-eight studies were included. Majority of the studies enrolled participants with mild to moderate Alzheimer's dementia. Outcome measures included objective sleep assessments including polysomnography (PSG) or actigraphy, caregiver reports, sleep logs, and rating scales. The effectiveness of current treatments for sleep disturbance in Alzheimer's dementia is poor. Of the non-pharmacological treatments, bright light therapy (BLT) has the best results. The pharmacological agents produce inconsistent results and their use is further limited by their potential adverse effects. Conclusion Most current treatments targeting sleep disturbance in Alzheimer's dementia are ineffective. There is a need for further investigation of interventions for treating sleep disturbance in Alzheimer's dementia.