Naharci Mehmet Ilkin, Ozturk Ahmet, Yasar Halit, Cintosun Umit, Kocak Necmettin, Bozoglu Ergun, Tasci Ilker, Doruk Huseyin
Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey.
Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Acta Neurol Belg. 2015 Dec;115(4):563-8. doi: 10.1007/s13760-015-0453-9. Epub 2015 Mar 17.
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.
该研究的目的是评估胆碱酯酶抑制剂对睡眠模式和睡眠障碍的影响。共有87名未接受胆碱酯酶抑制剂和美金刚治疗的轻至中度痴呆患者纳入该研究。根据临床医生的偏好,痴呆患者接受多奈哌齐、加兰他敏或卡巴拉汀治疗。55名痴呆患者(63.2%)完成了研究。23名认知功能正常的老年受试者作为对照组纳入研究。匹兹堡睡眠质量指数用于在研究开始时和最终评估时评估睡眠质量。与多奈哌齐组和对照组相比,加兰他敏治疗后匹兹堡睡眠质量指数评分变化方面睡眠质量改善更好。治疗后加兰他敏组匹兹堡睡眠质量指数评分显著降低。虽然在统计学上不显著,但卡巴拉汀治疗后降低了而多奈哌齐治疗后增加了匹兹堡睡眠质量指数评分。睡眠质量差的痴呆患者(n:36),加兰他敏组睡眠障碍改善率为81.8%,卡巴拉汀组为75%,多奈哌齐组为50%。就改善睡眠质量而言,加兰他敏可能是轻至中度痴呆患者胆碱酯酶抑制剂的首选。