Author(s): Hideto Shinno, Ichiro Ishikawa, Nobuo Ando, Jun Horiguchi and Yu Nakamura
Objective: Evidence of the effects of Yokukansan (YKS), a traditional herbal medicine, on behavioral and psychological symptoms of dementia (BPSD) has accumulated. As well as BPSD, patients with Alzheimer’s disease (AD) demonstrate poorer sleep quality. Specific sleep disorders such as sleep-disordered breathing and periodic limb movement disorder (PLMD) can be prevalent in the elderly. PLMs are generally considered to produce sleep fragmentation by provoking arousals. This study aimed to examine whether YKS alters polysomnography variables in patients with AD.
Methods: Seven patients (3 men and 4 women) with probable AD according to the standard criteria were investigated. Participants were treated with YKS for 4 weeks. The Neuropsychiatric Inventory for the assessment of BPSD, the Mini-Mental State Examination (MMSE) for cognitive function, polysomnography for evaluation of sleep structure and Pittsburgh Sleep Quality Index (PSQI) for subjective sleep quality, and Epworth Sleepiness Scale (ESS) were carried out at baseline and at the end of the treatment. The local institutional review boards approved this study. All patients gave written consent according to institutional guidelines and the tenets of the Declaration of Helsinki.
Results: Treatment with YKS resulted in a decreased NPI score, a prolonged total sleep time, a shortened sleep latency, an increased sleep efficiency, and decreased periodic limb movement during sleep. YKS also improved subjective evaluations with PSQI and ESS.
Conclusions: YKS was effective for BPSD and sleep disturbances in patients with AD. YKS did not induce daytime somnolence, extrapyramidal signs, or an increased apnea-hypopnea index.
