Lingering Challenges With Assessing, Treating Sleep Problems in Alzheimer Disease: Ruth Benca, MD, PhD

The professor and chair of Psychiatry & Human Behavior at Wake Forest School of Medicine discussed the need for improved tools to evaluate and treat sleep disorders in patients with Alzheimer disease. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"Having good clinical guidelines of how to assess and treat sleep problems in these patients, at the very least, are going to improve their quality of life and the quality of life of their caregivers. We need good longitudinal studies of treatments for these patients. There have been very few drugs that have been tested in patients with AD, and not a lot of that have been tested in older adults."

In addition to the numerous cognitive deficits patients with Alzheimer disease (AD) face, issues with sleep are also quite common, which can be disruptive to both the affected patient and their caregivers. People with AD experience sleep disturbances, including shorter or more fragmented sleep, changes to the biological clock and sleep cycle, and certain sleep disorders. The relationship between sleep issues and other symptoms of AD may be reciprocal as well, with sleep loss worsening other symptoms such as delusions, restlessness, and wandering.

Typically, nondrug treatment strategies for sleep changes are the first route taken by clinicians. This includes maintaining regular times for meals, encouraging regular daily exercise; avoiding alcohol, caffeine, and nicotine; and discouragement of watching television during periods of wakefulness, among others. In some cases, nondrug approaches fail to work, or the sleep changes are accompanied by disruptive nighttime behaviors. Some clinicians have turned to antipsychotic drugs, but these are considered with extreme caution, as studies have shown that these drugs are associated with increased risk of stroke and death in older adults with dementia.

At the 2022 SLEEP Annual Meeting, June 4-8, in Charlotte, North Carolina, Ruth Benca, MD, PhD, presented on the impact and management of sleep problems in patients with AD and their caregivers. Benca, professor and chair, Psychiatry & Human Behavior, Wake Forest School of Medicine, sat down with NeurologyLive® to discuss her presentation, including some of the complexities in conducting clinical trials that focus on sleep disorders in patients with AD. She stressed the need to improve the tools and assessments readily available, stating that the approaches used for non-AD patients are not applicable for everyone.

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