Galantamine improves sleep quality in patients with dementia

Abstract

The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality.

Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies

“… 147 For example, insomnia and nightmares are frequent side effects of donezepil 148 when it is administered at night but produces a slight improvement in sleep quality when administered in the morning. 149 Galantamine has the best profile regarding sleep and may be the first choice of cholinesterase inhibitor in mild-to-moderate dementia patients in terms of improving sleep quality. 149 – 151 One case of rivastigmine induced REM behavior disorder (RBD) has been reported.…”

“… 149 Galantamine has the best profile regarding sleep and may be the first choice of cholinesterase inhibitor in mild-to-moderate dementia patients in terms of improving sleep quality. 149 – 151 One case of rivastigmine induced REM behavior disorder (RBD) has been reported. 152 However, it seems that donezepil and rivastigmine might be effective to treat RBD.…”

Neural Correlates of Sleep Disturbance in Alzheimer’s Disease: Role of the Precuneus in Sleep Disturbance

“…The effectiveness of a cholinesterase inhibitor (ChEI) for sleep disturbance in AD is unclear. One observational study showed that galantamine improved sleep disturbance in AD and mixed type dementia, while donepezil did not do so [ 32 ]. ChEIs are thought to increase regional cerebral blood flow mainly in the frontal lobe [ 33 ], but a functional MRI study showed that galantamine increased functional connectivity in the posterior cingulate cortex and precuneus [ 34 ].…”

The effect of cholinesterase inhibitors on sleep in the patients with Alzheimer’s disease: an observational prospective study

“…Effect of cholinesterase inhibitors using PSQI on sleep was investigated in a study conducted by Naharci et al They found a superior decline in posttreatment PSQI score in patients using galantamine, although not statistically significant, in comparison with other groups of patients (donepezil, rivastigmine and controls) and they advised to use galantamine in dementia as a first-option medication [14]. In a randomized double-blind trial, donepezil and galantamine did not have deleterious effects on sleep, furthermore galantamine was found to be slightly more beneficial than of donepezil in terms of sleep quality [7].…”