Pharmacological interventions to improve sleep in people with Alzheimer’s disease: a meta-analysis of randomized controlled trials

Amy Bedward, Jasmine Kaur, Sadiyah Seedat, Holly Donohue, Chia Siang Kow, Muhammad Kamran Rasheed, Amaan Javed, Syed Shahzad Hasan

Research output: Contribution to journalReview articlepeer-review


Introduction: This systematic review and meta-analysis evaluates the evidence from randomized controlled trials (RCTs) involving pharmacological interventions for improving sleep in people with Alzheimer’s disease (AD). Methods: A systematic literature search in eight databases from January 2000 to July 2023 focusing on RCTs that compared a pharmacological intervention with a placebo for enhancing sleep in people with AD. The authors registered the study protocol at Prospero, followed the PRISMA guidelines, and produced the pooled estimates using random-effect or IVhet models. Results: Eight different interventions and 29 different sleep outcomes were examined in 14 RCTs included in this review. Eszopiclone positively affected sleep efficiency, as did orexin antagonists. However, there was no difference when melatonin was used. The interventions demonstrated low discontinuation rates and a few adverse drug reactions. Conclusion: Although melatonin was the most investigated intervention, the evidence for its efficacy is inconclusive. On the other hand, trazodone and orexin receptor antagonists showed promising results; however, more RCTs are needed for definite answers.

Original languageEnglish
Pages (from-to)527-539
Number of pages13
JournalExpert Review of Neurotherapeutics
Issue number5
Early online date10 Apr 2024
Publication statusPublished - 1 May 2024

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