P2‐221: Daytime hypersomnolence on the multiple sleep latency test in patients with dementia with Lewy bodies

Ferman, Tanis J.; Boeve, Bradley F.; Silber, Michael H.; Lin, Siong-Chi; Tippmann‐Peikert, Maja; Smith, Glenn E.

doi:10.1016/j.jalz.2008.05.1296

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“…Although a systematic review of 10 randomized, placebo-controlled, double-blind trials of cholinesterase inhibitors and memantine showed cholinesterase inhibitors to enhance cognitive function for patients with DLB [8], many other symptoms and features of DLB are not affected by this class of agents. Excessive daytime somnolence is increasingly being recognized in patients with DLB [3,4,6,9]. Analyses conducted using the Epworth Sleepiness Scale (ESS), a subjective measure of sleepiness, and the Multiple Sleep Latency Test, an objective measure of sleepiness, in patients with DLB have shown moderate to severe sleepiness using both measures [10].…”

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confidence: 99%

Efficacy, Safety, and Tolerability of Armodafinil Therapy for Hypersomnia Associated with Dementia with Lewy Bodies: A Pilot Study

Lapid¹,

Kuntz

Mason

et al. 2017

Dement Geriatr Cogn Disord

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Background/Aims: Hypersomnia is common in dementia with Lewy bodies (DLB). We assessed the efficacy, safety, and tolerability of armodafinil for hypersomnia associated with DLB. Methods: We performed a 12-week pilot trial of armodafinil therapy (125-250 mg orally daily) in DLB outpatients with hypersomnia. The patients underwent neurologic examinations, a neuropsychological battery, laboratory testing, electrocardiography, and polysomnography. Efficacy was assessed at 2, 4, 8, and 12 weeks. Safety assessment included laboratory examinations, QTc interval, and heart rate. Tolerability was assessed by analysis of adverse events. Data were analyzed using the last-observation-carried-forward method. Results: Of 20 participants, 17 completed the protocol. The median age was 72 years, most of the participants were men (80%), and most had spouses as caregivers. The Epworth Sleepiness Scale (p < 0.001), Maintenance of Wakefulness Test (p = 0.003), and Clinical Global Impression of Change (p < 0.001) scores improved at week 12. The Neuropsychiatric Inventory total score (p = 0.003), visual hallucinations (p = 0.003), and agitation (p = 0.02) improved at week 4. Caregiver overall quality of life improved at week 12 (p = 0.004). No adverse events occurred. Conclusion: These pilot data suggest improvements in hypersomnia and wakefulness and reasonable safety and tolerability of armodafinil therapy in hypersomnolent patients with DLB. Our findings inform the use of pharmacologic strategies for managing hypersomnolence in these patients.

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