Little evidence on effective pharmacotherapies for sleep disturbances in dementia

The evidence reviewed suggested melatonin was unlikely to be of benefit to patients with Alzheimer disease (AD) and moderate-to-severe dementia and sleep problems. There was some evidence that a low dose (50mg) of trazodone improved sleep in people with AD, although a larger trial would be needed to be able to draw a more definitive conclusion on the balance of risks and benefits. Until further evidence emerges, trazodone and other hypnotic drugs should be used with particular caution in patients with AD or other dementias, with careful assessment of the risks (of treatment and of no treatment), efficacy and adverse effects in individuals.