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Non-pharmacological interventions for sleep disturbances in people with dementia.

ABSTRACT:

SUBMITTER: Wilfling D

PROVIDER: S-EPMC9808594 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Non-pharmacological interventions for sleep disturbances in people with dementia.

Wilfling Denise D Calo Stella S Dichter Martin N MN Meyer Gabriele G Möhler Ralph R Köpke Sascha S

The Cochrane database of systematic reviews 20230103

<h4>Background</h4>Sleep disturbances occur frequently in people with dementia with a reported prevalence of up to 40%. Common problems are increased number and duration of awakenings and increased percentage of light sleep. Sleep disturbances are associated with a number of problems for people with dementia, their relatives, and carers. In people with dementia, they may lead to worsening of cognitive symptoms, challenging behaviours such as restlessness or wandering, and further harms, such as ...[more]

PMID: 36594432

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Project description:ObjectivesApproximately one third of people with dementia live on their own and they face an increased risk of unmet needs and loneliness. This systematic review aimed to identify and describe non-pharmacological interventions that have been evaluated for people with dementia living alone and to examine the effectiveness of these interventions.MethodsFollowing PRISMA guidelines, six databases were systematically searched: MEDLINE, Embase, CINAHL, PsycINFO, Social Care online, and ClinicalTrials.gov. Studies that reported on the impact or experience of an intervention for people with dementia living alone in the community (not long-term care) and that had been published since 2000 were included in the review. No restrictions were applied in terms of study design or outcome measures. Study risk of bias was assessed, and a narrative approach was used to synthesize findings.ResultsThirteen studies of 13 different interventions were included, grouped into five intervention categories: home-based dementia case/care management (n = 4), technology (n = 3), social (n = 3), cognitive (n = 2) and psychological (n = 1). There was one randomized controlled trial (RCT), and two economic evaluations that used data from RCTs. Most other studies were small-scale, and only two were evaluated to have low risk of bias. Most studies reported positive or mixed findings in terms of the intervention's impact on the person with dementia or aspects of feasibility. However, studies were heterogeneous in terms of intervention, study design, and outcomes.ConclusionsThis review of a limited body of research highlights the potential for interventions to support people with dementia who live alone. It also identifies key evidence gaps and the need for more robust and comparable research to better understand what works, why, for who, and how. Involving people with dementia who live alone in the design, implementation, and evaluation of these interventions will be crucial to ensure that their needs and preferences are met.

Project description:BackgroundSleep disturbances are common in people living with Human Immunodeficiency Virus (HIV) and may lead to poor adherence to antiretroviral therapy and worsen HIV symptom severity. Due to the side effects of pharmacotherapy for sleep disturbances, there is more room for non-pharmacological interventions, but knowledge of how these non-pharmacological interventions have been used to improve sleep in people living with HIV (PLWH) is still missing.ObjectiveTo investigate the content of non-pharmacological interventions, sleep measurements, and the impact of these interventions on improving sleep in PLWH.MethodsFollowing PRISMA guidelines, we conducted a systematic search on PubMed, EMBASE, Cochrane Central Registry of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc. Non-pharmacological interventions for improving sleep in PLWH were included, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. We performed a narrative approach to synthesize the data to better understand the details and complexity of the interventions.ResultsFifteen experimental studies in three categories for improving sleep in PLWH were included finally, including psychological interventions (components of cognitive-behavioral therapy for insomnia or mindfulness-based cognitive therapy, n = 6), physical interventions (auricular plaster therapy, acupuncture, and exercise, n = 8), and elemental interventions (speed of processing training with transcranial direct current stimulation, n = 1). Wrist actigraphy, sleep diary, and self-reported scales were used to measure sleep. Psychological interventions and physical interventions were found to have short-term effects on HIV-related sleep disturbances.ConclusionsPsychological and physical interventions of non-pharmacological interventions can potentially improve sleep in PLWH, and the combination of patient-reported outcomes and actigraphy devices can help measure sleep comprehensively. Future non-pharmacological interventions need to follow protocols with evidence-based dosing, contents, and measures to ensure their sustainable and significant effects.

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Non-pharmacological interventions for sleep disturbances in people with dementia.

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Non-pharmacological interventions for sleep disturbances in people with dementia.

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