Pharmacological interventions to improve sleep in people with Alzheimer's disease: a meta-analysis of randomized controlled trials.
Study Goal
The researchers aimed to evaluate the efficacy of pharmacological interventions, including melatonin, for improving sleep in people with Alzheimer's disease.
Results Summary
The study found no significant difference in sleep outcomes when melatonin was used, despite it being the most investigated intervention. The evidence for melatonin's efficacy was deemed inconclusive.
Population
People with Alzheimer's disease
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Eszopiclone | increase | sleep efficiency | people with Alzheimer's disease | - | positively affected | #1 |
orexin antagonists | increase | sleep efficiency | people with Alzheimer's disease | - | positively affected | #2 |
melatonin | no change | - | people with Alzheimer's disease | - | no difference | #3 |
pharmacological interventions | decrease | discontinuation rates | people with Alzheimer's disease | - | low discontinuation rates | #4 |
pharmacological interventions | decrease | adverse drug reactions | people with Alzheimer's disease | - | a few adverse drug reactions | #5 |
melatonin | no change | efficacy | people with Alzheimer's disease | - | evidence for its efficacy is inconclusive | #6 |
trazodone | increase | - | people with Alzheimer's disease | - | showed promising results | #7 |
orexin receptor antagonists | increase | - | people with Alzheimer's disease | - | showed promising results | #8 |
INTRODUCTION: This systematic review and meta-analysis evaluates the evidence from randomized controlled trials (RCTs) involving pharmacological interventions for improving sleep in people with Alzheimer's disease (AD). METHODS: A systematic literature search in eight databases from January 2000 to July 2023 focusing on RCTs that compared a pharmacological intervention with a placebo for enhancing sleep in people with AD. The authors registered the study protocol at Prospero, followed the PRISMA guidelines, and produced the pooled estimates using random-effect or IVhet models. RESULTS: Eight different interventions and 29 different sleep outcomes were examined in 14 RCTs included in this review. Eszopiclone positively affected sleep efficiency, as did orexin antagonists. However, there was no difference when melatonin was used. The interventions demonstrated low discontinuation rates and a few adverse drug reactions. CONCLUSION: Although melatonin was the most investigated intervention, the evidence for its efficacy is inconclusive. On the other hand, trazodone and orexin receptor antagonists showed promising results; however, more RCTs are needed for definite answers.