Beneficial treatment of age-related sleep disturbances with prolonged intranasal vasopressin

Disturbed sleep is common in the elderly and is characterized by disordered sleep architecture with reduced time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep. At present, no treatments are available to fully compensate for these disorders. In the elderly, vasopressin content is decreased at various brain sites. Investigating the effects of a 3-month intranasal vasopressin administration on sleep and cognitive functions in two elderly subjects in a foregoing pilot study, the authors found that the most pronounced influence of the peptide was a marked increase in SWS. Thi s placebo-controlled, double-blind, randomized study examined the influence s of a 3-month period of daily intranasal vasopressin treatment (20 IU befo re bedtime and after awakening) on nocturnal sleep in 26 healthy elderly su bjects (mean age, 74.2 years). Intranasal treatment of vasopressin increase d (1) the total sleep time, on average, by 45 minutes (p < 0.002); (2) time spent in SWS by 21 minutes (p < 0.025); and (3) time in REM sleep in the s econd half of the night by 10 minutes (p < 0.01). Vasopressin promotes slee p time and improves sleep architecture after prolonged intranasal administr ation in elderly subjects, although scores of subjective sleep quality did not change. Results suggest that age-related deterioration of sleep archite cture can benefit from intranasal treatment with vasopressin. But a potenti al use in clinical settings will also depend on demonstrating improved subj ective sleep quality, which remained unaffected by vasopressin in this stud y of elderly subjects.