The Effect of Rivastigmine Transdermal Patch on Sleep Apnea in Patients with Probable Alzheimer’s Disease

Sleep disturbance in patients with probable Alzheimer’s disease (AD) are frequent and disabling features, affecting approximately 25–60% of all patients. The most common sleep related complaints are insomnia, sleep fragmentation and excessive daytime sleepiness, frequently accompanied by sleep apnea in patients with probable AD.1 Change in sleep precedes the onset of cognitive symptoms in patients with AD, and a strong association exists between disrupted sleep and the development of AD.2 Cholinergic neuronal loss of Meynert nucleus in the basal forebrain is a pathophysiological hallmark of AD, and cholinergic activity in the central nervous system influences upper airway opening via the central and peripheral mechanism. Decreased thalamic pontine cholinergic projections may affect the respiratory drive, leading to both central and obstructive apnea in neurodegenerative diseases, including AD.3,4 The primary pharmacological treatments approved for AD are central acting cholinesterase inhibitors, and rivastigmine transdermal patches are frequently used in mild to moderate AD. The aim of this study was to evaluate the effects of rivastigmine transdermal patches on sleep architectures and sleep apnea in patients with probable AD.