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Identifying and Treating Insomnia in Patients Living With Alzheimer’s Disease
Overview
For people living with Alzheimer disease, sleep disturbances are often problematic for the patient and their family. In this CME webcast, watch short videos to gain insight from experts into the recognition and treatment of insomnia in these patients.
Abstract
The number of patients with Alzheimer’s disease (AD) is increasing significantly. The disease affects many aspects of a person’s life, and often sleep disturbances are problematic for the patient and for their family. It is critical for clinicians to monitor patients with AD for sleep disorders, including insomnia. Because insomnia can also be an indicator of future development of cognitive difficulties, intervening as early as possible with pharmacologic and nonpharmacologic treatment strategies may enable clinicians to not only manage the patient’s sleep disorder but also prevent and/or delay the onset of AD.
To cite: Avidan A, Burke A. Identifying and treating insomnia in patients living with Alzheimer’s disease. J Clin Psychiatry. 2020;81(3):ME19014WC1C.
To share: https://doi.org/10.4088/JCP.ME19014WC1C
© Copyright 2020 Physicians Postgraduate Press, Inc.
Target Audience
Psychiatrists, nurse practitioners, physicians assistants
Learning Objectives
After completing this educational activity, you should be able to:
- Regularly assess patients with Alzheimer’s disease (AD) for sleep disturbances using patient and care partner interviews and sleep diaries
- Provide education, support, and behavioral and environmental interventions to patients with AD and their care partners to manage factors that contribute to sleep disturbances
- Using strategies to maximize safety, provide pharmacologic interventions to treat insomnia in patients with AD as appropriate within a holistic approach that incorporates shared decision-making
Support Statement
Supported by an educational grant from Merck & Co, Inc.
Learning Objectives
After completing this educational activity, you should be able to:
- Regularly assess patients with Alzheimer’s disease (AD) for sleep disturbances using patient and care partner interviews and sleep diaries
- Provide education, support, and behavioral and environmental interventions to patients with AD and their care partners to manage factors that contribute to sleep disturbances
- Using strategies to maximize safety, provide pharmacologic interventions to treat insomnia in patients with AD as appropriate within a holistic approach that incorporates shared decision-making
Release, Review, and Expiration Dates
This webcast activity was published in April 2020 and is eligible for AMA PRA Category 1 Credit™ through April 30, 2022. The latest review of this material was March 2020.
Statement of Need and Purpose
Insomnia occurs in up to one-third of patients with dementia and can affect patients’ emotional and physical health, worsen cognitive symptoms, and reduce quality of life for patients and care partners. Clinicians must regularly assess sleep, educate care partners, and provide safe and effective treatment to patients who are experiencing insomnia. Recognizing insomnia in these patients can be challenging; tools and informant reports can aid clinicians. Education is needed on the assessment of sleep disturbances in patients with dementia as well as factors contributing to insomnia. Additionally, clinicians have substantial uncertainty about the efficacy and adverse effects of various sleep treatments in people with dementia, and the literature base is small. Clinicians would benefit from expert guidance that addresses dosing in trial data, package information, and real-world experience. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on insomnia and dementia.
Disclosure of Off-Label Usage
The chair has determined that, to the best of his knowledge, none of the pharmaceutical agents discussed are approved by the US Food and Drug Administration for the treatment of insomnia in patients with Alzheimer disease.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
Acknowledgment
This webcast is derived from the teleconference series “Identifying and Treating Insomnia in Patients Living with Alzheimer’s Disease,” which was held in October and December 2019 and supported by an educational grant from Merck & Co, Inc.
Faculty Affiliation
Alon Y. Avidan, MD, MPH
David Geffen School of Medicine at the University of California, Los Angeles, California
Anna D. Burke, MD
Barrow Neurological Institute, Phoenix, Arizona
Financial Disclosure
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosures are as follows:
The Chair for this activity, Alon Avidan, MD, MPH, is a consultant for Balance Therapeutics, Best Doctors, Eisai, Harmony Biosciences, and Merck and is a member of the speaker/advisory board for Harmony Biosciences. Anna Burke, MD has no personal affiliations or financial relationships with any commercial interest to disclose relative to the activity.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
MOC Approval Statement
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Identifying and Treating Insomnia in Patients Living with Alzheimer’s Disease has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC Part II CME Activity
Psychiatry and Neurology
Available Credit
- 1.75 AMA PRA Category 1 Credit™
- 1.75 Participation