title: Treatment of Sleep Disorders in Dementia.
abstract: 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.
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.|Radboud Alzheimer Centre, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Sharon
authors.initials: S
authors.lastname: Ooms
authors.affiliation: Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, Saint Louis, MO, 63110, USA. juy@neuro.wustl.edu.
authors.forename: Yo-El
authors.initials: YE
authors.lastname: Ju
keywords: Alzheimer’s disease; Circadian; Dementia; Dementia with Lewy bodies; Frontotemporal dementia; Insomnia; Lewy body disease; Parkinson’s disease with dementia; REM sleep behavior disorder; Sleep; Vascular dementia