Pharmacological Management of Insomnia in Patients with Vascular Dementia

Introduction: Sleep disturbance is common in vascular dementia. We sought to review the management of insomnia in patients with vascular dementia. This group suffers from significantly decreased sleep efficiency, experienced disruption in sleep-wake cycles, and higher sleep disturbance, even when compared to other types of dementia. Methods: A literature search was conducted across Google Scholar, PubMed, and Ovid (all resources); eight articles met inclusion criteria. Results: The review found that melatonin, choto-san, medical cannabis, and gabapentin show potential as effective treatments of sleep disturbance in patients with vascular dementia. However, the evidence base is limited. Discussion: While the medications studied showed some signs of effectiveness, more research is needed. In particular, there needs to be a disaggregation of data into specific dementia diagnoses. More research is needed, particularly on vascular dementia. We suggest considering actigraphy before prescribing and during treatment to assess whether the medication is having an objective effect.