Analysis of the effects of galantamine and donepezil on sleep disturbances in patients with dementia

Analysis of the effects of galantamine and donepezil on sleep disturbances in patients with dementia Objective: Sleep disturbances occur in various forms of dementia. In this study, the aim was to investigate the effects of galantamine and donepezil on sleep disturbances in patients with dementia. Method: Subjects, who were admitted to a geriatric outpatient clinic between January 2008 and December 2010, were enrolled in the study. Subjects, who were started on anti-dementia drugs, were assessed. Thirty-eight dementia patients (27 female, 11 male) having sleep disturbances in the beginning were included in the study. The dementia patients were treated with galantamine (n=22) or donepezil (n=16) according to the clinician's opinion. To detect sleep disturbances previously the same prepared questions were directed to all of the subjects and/or their caregivers and the responses were evaluated at baseline and after 24 weeks. Results:There was no difference in descriptive characteristics among the groups (p>0.05, for all comparisons). When the changes in test scores aimed at evaluating cognition at the baseline and at week 24 were compared between the two treatment groups, there was no significant difference (p>0.05, for all comparisons). Using a univariate logistic regression analysis, it was found that galantamine had a 5 times more favorable effect on sleep disturbances than donepezil and that this difference was significant (p=0.046, Odds ratio=0.203, Confidence interval=0.030-1.2311. When the effects of drugs on sleep conditions were evaluated in multiple regression analysis, it was found that sleep disturbances continued in subjects using anti-psychotic drugs (p=0.045, Odds ratio=0.072, Confidence interval=0.006-0.947). Conclusions: Based on our results, galantamine use improved sleep disturbances significantly more than donepezil in dementia patients in univariate logistic regression analysis. The disappearance of this helpful effect in multiple logistic regression analysis may be related to anti-psyhotic drug use. Consideration of our findings when choosing medications for newly diagnosed dementia patients, especially for those with sleep disturbance, may be beneficial. In addition careful follow-up may be needed to assess sleep disturbances in dementia patients when anti-psychotic drugs are being