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Treatment Options for Sleep Disturbances in Dementia: A Systematic Review
Duc Viet Pham1, Arnim Quante1,2
1Charité - University Medicine Berlin, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Berlin, Germany.
Journal of Geriatric Psychiatry and Neurology
|March 23, 2026
Summary
This review found that eszopiclone (a Z-drug), low-dose lemborexant (an orexin receptor antagonist), and PARO social stimulation show promise for improving sleep disturbances in dementia patients. However, more research is needed, especially for non-pharmacological options.
Area of Science:
- Gerontology
- Sleep Medicine
- Clinical Pharmacy
Background:
- Sleep disturbances are a significant clinical challenge for individuals with dementia.
- Current pharmacological and non-pharmacological interventions for dementia-related sleep issues have limited evidence from controlled trials.
- Recent research (2020-2025) offers new insights into effective strategies.
Purpose of the Study:
- To systematically review recent evidence on interventions for sleep disturbances in dementia.
- To evaluate the efficacy of both pharmacological and non-pharmacological approaches.
- To identify promising interventions based on controlled trial data.
Main Methods:
- Systematic review of eight randomized controlled trials (RCTs) involving 666 participants with dementia and sleep disturbances.
- Searches conducted via MEDLINE, with screening following PRISMA guidelines; non-randomized or non-intervention studies were excluded.
- Risk-of-bias assessed using Cochrane RoB2, and effect sizes (Cohen's d) calculated in R.
Main Results:
- Z-drugs, particularly eszopiclone, demonstrated significant improvements in sleep efficiency and latency.
- Low-dose lemborexant (2.5 mg) showed favorable results for nocturnal awakenings among orexin receptor antagonists.
- Social stimulation with PARO positively impacted sleep time and efficiency, while light therapy reduced nocturnal awakenings; music therapy had minimal effect.
Conclusions:
- Eszopiclone, low-dose lemborexant, and PARO social stimulation present favorable profiles for managing dementia-related sleep disturbances.
- Pharmacological interventions require careful risk-benefit assessment; non-pharmacological options are safer but require further research.
- Standardizing outcomes and tailoring interventions to individual patient needs are crucial for future research.
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