title: Co-use of donepezil and hypnotics among Alzheimer's disease patients living in the community.
abstract: BACKGROUND
  In clinical trials, sleep problems have been identified as side effects of donepezil, an acetylcholinesterase (AChE)-inhibiting medication for the treatment of Alzheimer's disease (AD). Poor sleep quality can exacerbate behavior problems among patients and add to the burden experienced by their caregivers. We examined the relationship between co-use of donepezil and hypnotics in a large sample of persons with AD living in the community.
  
  
  METHODS
  This secondary data analysis used cross-sectional subjects from a multiwave, consumer-based survey of AD caregivers conducted in 1997 and 1998. Rates of hypnotic use among users and non-users of donepezil were compared using chi-square analysis for independent samples, and multivariate logistic regression was used to identify significant independent correlates of hypnotic use.
  
  
  RESULTS
  A total of 2638 caregivers completed at least 1 study wave. Use of hypnotics was higher in the donepezil subgroup (9.78%) compared with subjects not taking this medication (3.93%). Multivariate analysis demonstrated that donepezil use was independently linked to increased hypnotic use after controlling for the potential confounding effects of disruptive behavior and depressive symptoms (adjusted odds ratio = 3.34, p <.001).
  
  
  CONCLUSIONS
  In this large community sample, donepezil use was statistically linked to increased hypnotic use. Because sleep quality may be a critical issue for persons with AD and their caregivers, more rigorous evaluation of sleep problems linked to AChE-inhibitor treatment is indicated.
authors.affiliation: Department of Psychiatry, University of California at San Diego and Neuroscience Education Institute, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Stahl
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Markowitz
authors.forename: Elane M
authors.initials: EM
authors.lastname: Gutterman
authors.forename: George
authors.initials: G
authors.lastname: Papadopoulos
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D000077265:Donepezil; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007189:Indans / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D019338:Polypharmacy; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D002800:Cholinesterase Inhibitors; D006993:Hypnotics and Sedatives; D007189:Indans; D010880:Piperidines; D000077265:Donepezil