Treatment of Sleep Disorders in Dementia
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Sleep and circadian disorders occur frequently in all types of dementia. Due to the multifactorial nature of sleep problems in dementia, we propose a structured approach to the evaluation and treatment of these patients. Primary sleep disorders such as obstructive sleep apnea should be treated first. Comorbid conditions and medications that impact sleep should be optimally managed to minimize negative effects on sleep. Patients and caregivers should maintain good sleep hygiene, and social and physical activity should be encouraged during the daytime. Given the generally benign nature of bright light therapy and melatonin, these treatments should be tried first. Pharmacological treatments should be added cautiously, due to the risk of cognitive side effects, sedation, and falls in the demented and older population. Regardless of treatment modality, it is essential to follow patients with dementia and sleep disorders closely, with serial monitoring of individual response to treatment.
KeywordsSleep Insomnia Circadian Dementia Alzheimer’s disease Dementia with Lewy bodies Lewy body disease Vascular dementia Frontotemporal dementia Parkinson’s disease with dementia REM sleep behavior disorder
Compliance with Ethical Standards
Conflict of Interest
Sharon Ooms declares no conflict of interest.
Yo-El Ju has received a grant from Philips Respironics and personal fees from C2N Diagnostics, the American Academy of Neurology, and the American Academy of Sleep Medicine.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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