Donepezil improves obstructive sleep apnea in Alzheimer disease: a double-blind, placebo-controlled study.
BACKGROUND
There is an association between Alzheimer disease and sleep-disordered breathing. Donepezil is the drug most frequently used to treat cognitive symptoms in Alzheimer disease. This study evaluates the effects of donepezil on obstructive sleep apnea in patients with Alzheimer disease.


METHODS
Randomized, double-blind, placebo-controlled design. Twenty-three patients with mild-to-moderate Alzheimer disease and apnea-hypopnea index (AHI) > 5/h were allocated to two groups: donepezil treated (n = 11) and placebo treated (n = 12). Polysomnography and cognitive evaluation using Alzheimer disease assessment scale-cognitive (ADAS-cog) subscale were performed at baseline and after 3 months. Cognitive and sleep data were analyzed using analysis of variance.


RESULTS
AHI and oxygen saturation improved significantly after donepezil treatment compared to baseline and placebo (p < 0.05). Rapid eye movement (REM) sleep duration increased after donepezil treatment (p < 0.05). ADAS-cog scores improved after donepezil treatment, although they did not correlate with REM sleep increase and sleep apnea improvement (p < 0.01).


CONCLUSIONS
Donepezil treatment improved AHI and oxygen saturation in patients with Alzheimer disease. Treatment also increased REM sleep duration and reduced ADAS-cog scores.


BACKGROUND
ClinicalTrials.gov Identifier: NCT00480870.
Moraes
Walter
W
Psychobiology Department, Universidade Federal de São Paulo, São Paulo, Brazil. waltermoraes@giro.com.br
Poyares
Dalva
D
Sukys-Claudino
Lucia
L
Guilleminault
Christian
C
Tufik
Sergio
S
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D000077265:Donepezil; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D017286:Polysomnography; D011594:Psychometrics / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology; D016896:Treatment Outcome
D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil