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First published online on January 15, 2008
Chest, doi:10.1378/chest.07-1446
A more recent version of this article appeared on March 1, 2008
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Donepezil improves obstructive sleep apnea in Alzheimer's disease: a double-blind placebo-controlled study

Walter A.S. Moraes, MD., PhD1; Dalva L. R. Poyares, MD, PhD1; Lucia Sukys-Claudino, MD1; Christian Guilleminault, MD, PhD2 and Sergio Tufik, MD, PhD1

1Psychobiology Department, Universidade Federal de São Paulo, São Paulo, SP, Brazil Napoleão de Barros, 925 São Paulo, SP 04024-002 Brazil Phone: 55-11-2149-0155 2Human Sleep Research Center Department of Psychiatry and Behavioral Science School of Medicine, Stanford University, 780 Welch Road, Palo Alto, CA 94304 USA Phone: 1-650- 723-6601

waltermoraes{at}giro.com.br

Abstract

BackgroundThere is an association between Alzheimer's disease and sleep disordered breathing. Donepezil is the drug most frequently used to treat cognitive symptoms in Alzheimer's disease. This study evaluates the effects of donepezil on obstructive sleep apnea in patients with Alzheimer's disease.

MethodsRandomized, double-blind, placebo-controlled design. Twenty-three patients with mild to moderate Alzheimer's disease and AHI >5 were allocated to two groups, donepezil-treated (n=11) and placebo-treated (n=12). Polysomnography and cognitive evaluation using ADAS-cog subscale were performed at baseline and after 3 months. Cognitive and sleep data were analyzed using ANOVA.

ResultsAHI and oxygen saturation improved significantly after donepezil treatment compared to baseline and placebo (p<0.05). REM sleep duration increased after donepezil treatment (p<0.05). ADAS-cog scores improved after donepezil treatment although did not correlate with REM sleep increase and sleep apnea improvement (p<0.01).

ConclusionsDonepezil treatment improved AHI and oxygen saturation in patients with Alzheimer's disease. Treatment also increased REM sleep duration and reduced ADAS-cog scores.

Key Words: sleep apnea • oxygen saturation • Alzheimer • donepezil • REM sleep • polysomnography






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