Effect of Donepezil on Sleep and Activity in Alzheimer’s Disease: Actigraphic and Polysomnographic Assessment

Aim: To examine the effect of donepezil on sleep and daily activity in patients with Alzheimer-type dementia (ATD) using polysomnography and actigraphy. Methods: Ten patients with mild to moderate ATD (mean age: 76 ± 6.2 years) were studied. The Alzheimer’s disease Assessment Scale-cognitive component-Japanese version (ADAS-Jcog),polysomnography, and 7-day recording of actigraphy data were performed. Following this baseline assessment, donepezil (5 mg daily) was administered every morning for 6 weeks, after which the ADAS-Jcog, polysomnography, and actigraphy were repeated. Results: After 6 weeks of treatment with donepezil, daily activity was significantly increased (276.2 ± 89.2 vs. 326.1 ± 98.6; p < 0.05). Similarly, rapid eye movement (REM) sleep (11.3 ± 4.1 vs. 17.1 ± 4.4; p<0.01) and sleep efficiency (76.2 ± 16.3 vs. 82.8 ± 10.6; p<0.05) were significantly increased compared with baseline. Although the ADAS-Jcog score did not decrease significantly (18.5 ± 6.8 vs. 15.9 ± 7.3; P= 0.054), there was a significant positive correlation between the decrease of this score and the increase of daily activity (r= 0.2137, p= 0.4809). Conclusions: An increase of daily activity and cognition were induced by donepezil treatment in patients with ATD, possibly based on improvement of the sleep structure. Trial Registration: Controlled-trials. Com Identifier: UMIN000005018