Individuals with mild cognitive impairment (MCI) who received a structured behavioral intervention in a randomized clinical trial (NCT02926157) designed to reset their circadian rhythms had improved sleep quality compared to those who did not receive the intervention. The chronotherapy intervention included sleep hygiene education, bright light therapy, physical activity phone counseling, and physical activity tracking.
Participants who received the intervention had significantly improved objectively measured sleep efficiency (P =.03), sleep fragmentation (P = .02), wake after sleep onset (P =.04), and subjective sleep quality (P = .03) compared with those on a waitlist for the intervention. The improvements were seen at 12 weeks for the objectively measured outcomes and at 24 weeks for the subjectively measured outcomes.
“Our results provide new evidence that a personalized behavioral medicine approach may help realign the biological clock to improve sleep quality in adults with mild cognitive impairment,” said Ryan Falck, MSc, University of British Columbia and study author. “Our hope is that, by improving sleep quality, we can contribute to preventing further cognitive decline in older adults with mild cognitive impairment.”
In another study (NCT03001557), treatment with lemborexant (Eisai; Woodcliff Lake, NJ), an investigational agent being studied for treatment of insomnia, decreased nighttime activity for individuals with mild-to-moderate Alzheimer’s dementia (AD) who had irregular sleep-wake rhythm disorder (ISWRD)—numerous naps in 24 hours and inability to sustain a full night’s sleep.
“We know that sleep disturbances are a significant problem for persons with Alzheimer’s disease and their caregivers,” said Margaret Moline, PhD, international clinical team lead for lemborexant at Eisai, “This pilot study provides preliminary evidence that lemborexant may help improve circadian rhythms to improve sleep patterns.”
A third study (NCT02750306) showed that people with both AD and insomnia treated with suvorexant had a relative increase in sleep of 28 minutes per night compared with those who received placebo (P < .005).
Results of all 3 studies were presented at the Alzheimer’s Association International Conference in Los Angeles, July 14-18, 2019.
Audrius V. Plioplys, MD
Michael S. Cartwright, MD, MS, and Hwajin Lee, MD