Care home residents with dementia: Prevalence, incidence, and associations with sleep disturbance in an English cohort study

Abstract

Introduction: People living with dementia in care homes often have sleep disturbances, but little is known about incidence and importance. Methods:We interviewed 1483 participants in 97 care homes and report prevalence, 1-year incidence, and baseline associations of clinically significant sleep disturbance in people with dementia.Results: Baseline prevalence of clinically significant sleep disturbance was 13.7% (200/1460); 31.3% (457/1462) had them at least once over 16 months. One-year incidence was 25.2%. At baseline, residents with sleep disturbance had lower quality of life (mean difference -4.84; 95% confidence interval [CI] -6.53 to -3.16) and were more frequently prescribed sleep medications (odds ratio 1.75; CI 1.17 to 2.61) than other residents.Discussion: Approximately one-third of care home residents with dementia have or develop sleep disturbances over 1 year. These are associated with lower quality of life and prescription of sedatives, which may have negative outcomes; therefore, it is important to develop effective treatments.

Timed Activity to Minimize Sleep Disturbance in People With Cognitive Impairment

“…Sleep disturbances occur in over 60% of persons living with cognitive impairment and present with symptoms such as irregular sleep–wake rhythms, daytime hypersomnia, frequent night awakenings, and poor sleep efficiency ( Webster et al, 2020 ). In persons living with cognitive impairment, sleep disturbances are associated with poor quality of life (QOL; Hodgson et al, 2014 ; Regier et al, 2020 ; Webster et al, 2022 ) and neuropsychiatric symptoms such as agitation, depression, disinhibition, and aberrant motor behavior ( Garcia-Alberca et al, 2013 ; Webster et al, 2020 ). Symptoms resulting from sleep disturbances are associated with increased care partner stress, burden, and decreased QOL, and increased morbidity and mortality in persons living with cognitive impairment ( Cothran et al, 2022 ; Petrovsky et al, 2018 ).…”

Understanding primary care diagnosis and management of sleep disturbance for people with dementia or mild cognitive impairment: a realist review protocol

“…Both the current literature17 26 27 and consultations with our stakeholders highlight the importance of investigating techniques that alleviate sleep disturbance among PLwD or MCI. Following the Medical Research Council’s framework for developing and evaluating complex interventions,28 this review is the first work package of a larger research programme that aims to gather data to better understand sleep disturbance in dementia and MCI populations.…”