Curr Treat Options Neurol (2016) 18:40 DOI 10.1007/s11940-016-0424-3 Dementia (E McDade, Section Editor) Treatment of Sleep Disorders in Dementia Sharon Ooms, MSc1,2 Yo-El Ju, MD MSCI3,* Address 1Department of Geriatric Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands 2Radboud Alzheimer Centre, Radboud University Medical Centre, Nijmegen, The Netherlands *3Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, Saint Louis, MO, 63110, USA Email:
[email protected] * Springer Science+Business Media New York 2016 This article is part of the Topical Collection on Dementia Keywords Sleep I Insomnia I Circadian I Dementia I Alzheimer’s disease I Dementia with Lewy bodies I Lewy body disease I Frontotemporal dementia I Parkinson’s disease with dementia I REM sleep behavior disorder Opinion statement Sleep and circadian disorders occur frequently in all types of dementia. Due to the multifactorial nature of sleep problems in dementia, we propose a structured approach to the evaluation and treatment of these patients. Primary sleep disorders such as obstructive sleep apnea should be treated first. Comorbid conditions and medications that impact sleep should be optimally managed to minimize negative effects on sleep. Patients and caregivers should maintain good sleep hygiene, and social and physical activity should be encouraged during the daytime. Given the generally benign nature of bright light therapy and melatonin, these treatments should be tried first. Pharmacolog- ical treatments should be added cautiously, due to the risk of cognitive side effects, sedation, and falls in the demented and older population. Regardless of treatment modality, it is essential to follow patients with dementia and sleep disorders closely, with serial monitoring of individual response to treatment.