Polysomnographic evaluation of patients with different types of dementia and treatment with cholinsterase Inhibitors, first results

Disturbance of sleep-wake pattern is a prominent feature in patients with dementia. In an ongoing study polysomngraphy was registered in 18 patients including dementia of Alzheimer (AD) and Lewy body type and frontotemporal dementia (FTD). In five patients with a monotherapy of donepezil or galantamine over two months sleep EEG could be assessed twice.

The preliminary results show, that all patients present with a substantial sleep continuity disturbance, which exceeds the subjectively assessed sleep complaints. REM-sleep was less reduced in FTD than in AD. Sleep related apnea and periodic leg movements (PLMS) were frequently found. After cholinergic treatment sleep pattern tended to normalize and REM-sleep increased. No association between sleep EEG parameters and cognitive performance (CERAD) was observed.

These results show that disturbance of sleep continuity is frequent in patients with dementia, probably intensified by sleep apnea and PLMS. Cholinergic treatment may exert beneficial effects on sleep pattern.