DORA and LP in Alzheimer's Disease Biomarkers
Status: Recruiting

The purpose of this study is to see if the sleep aid, lemborexant, can decrease the amount of amyloid-beta and tau in the fluid around the brain known as cerebrospinal fluid (CSF). Amyloid-beta and tau are proteins involved in the disease process leading to Alzheimer's disease.

Eligibility:
- EligibilityCriteria: Inclusion Criteria:  Male or female. Any race or ethnicity. Participants must be age ≥ 65 years and able to sign informed consent. Global Clinical Dementia Rating (CDR) 0. Willing and able to undergo study procedures.  Exclusion Criteria:  History or reported symptoms suggestive of restless legs syndrome, narcolepsy, or parasomnia. STOP-Bang score ≥ 6. Untreated sleep apnea AHI>15 Poorly treated sleep apnea with <4 hours/night <70% of the nights for 30 days prior to enrollment or undertreated OSA defined as an AHI ≥10. Negative plasma amyloid-beta and tau test Contraindication to lumbar puncture (anticoagulants; bleeding disorder; allergy to lidocaine or disinfectant; prior central nervous system or lower back surgery). Stroke.  History of renal impairment  Defined as patients with markers of kidney damage or eGFR ≤ 60 ml/min/1.73m2. Normal Limits > 60.0 mL/min/1.73m2  History of hepatic impairment  AST and/or ALT ≥ 2X upper limit of normal (ULN). Normal Limits: AST 11-47 IU/L and ALT 6-53 IU/L HIV/AIDS. Body mass index >35. History of substance abuse or alcoholism in the preceding 6 months. Regular alcohol consumption 3 or more days a week over the last 6 months. Regular alcohol consumption is defined as having more than 2 alcoholic beverages within 3 hours of bedtime. Participants that agree to reduce alcohol consumption during the study may not be excluded. History of presence of any clinically significant medical condition, behavioral or psychiatric disorder, or surgical history based on medical record or participant report that could affect the safety of the participant or interfere with study assessments or in the judgement of the Principal-Investigator (PI) if participant is not a good candidate.  Has any medical condition that, in the PI's or study team investigator's opinion, could increase risk to the participant, limit the participant's ability to tolerate the research procedures, or interfere with the collection/analysis of the data. Potential medical conditions that will be exclusionary at the PI's or study team investigator's discretion:  Cardiovascular disease requiring medication except for controlled hypertension. Pulmonary disease. Type I diabetes. Neurologic or psychiatric disorder requiring medication. Untreated depression Tobacco use. Use of sedating medications. Use of medications that interact with lemborexant (if cannot be discontinued). Abnormal safety labs. History of current suicidal ideations. Inability to speak and understand English. Currently pregnant or breast-feeding. In the opinion of the PI, the participant should be excluded due to an abnormal physical examination. Must not have participated in any clinical trial involving a study drug or device within the 30-days prior to study enrollment. Must not participate in another drug or device study prior to the end of this study participation. - HealthyVolunteers: Accepts Healthy Volunteers - Gender: All - MinimumAge: 65 Years - StdAgeList: Older Adult