For the treatment of CRSD in AD patients, no well-established drug therapy is currently available and non-drug therapy is recommended as the first choice of treatment. CRSD in AD patients is usually treated in the same way as for sleep disorder in the elderly; the aim is to promote good sleep during the night and maintain daytime activity levels.
The most important non-drug therapy is sleep hygiene therapy (SHT). The recommended SHT procedures for AD patients are available on the Alzheimers association website. In addition to these therapies, the provisions of correct knowledge about sleep and cognitive therapy for reducing excessive anxiety over insomnia are also recommended. Especially in patients with advanced dementia, for whom recording precise activity levels is often difficult, it may be helpful to present objective measures of activity levels, such as actigraphy data, so that they can realize the discrepancy between self-rated and objectively measured activity levels. For circadian rhythm disorder, the effectiveness of bright light therapy (BLT) has been suggested. BLT aims to improve sleep disorder by changing the phases of circadian rhythm by irradiating high-intensity light of 2500-10000 lux for 30 to 120 minutes during a certain time frame of the day. This therapy is also used for treating primary insomnia in the elderly, who exhibit physiological age-related changes in circadian rhythm, such as attenuation, advanced phase and impaired synchronization. For dementia patients with sleep/wake disorder, high-intensity light irradiation given in the morning after getting up can reduce night insomnia, daytime sleepiness and abnormal behaviors, such as delirium. In terms of the effect of BLT on plasma melatonin level in AD patients, a 4-week treatment with morning BLT has been shown to increase the amplitude of melatonin secretion rhythm in patients with mild AD.
Last date updated on August, 2020