New knowledge on the impact of sleep disturbances illustrates the urgent need to address sleep problems in nursing home residents

Sleep disturbance in people living with dementia or mild cognitive impairment: a realist review of general practice

“…Some concerns from the themes above, such as limited awareness of sleep disturbance, also apply to staff working in these settings. 28 , 29 , 31 , 32 , 37 Care home staff were reluctant to implement sleep hygiene practices for PLwD or MCI for a range of reasons. 64 As a result of environmental, resource, and policy-driven challenges, care homes reportedly imposed rigid routines for residents regardless of their individual circumstances.…”

“…Most studies focussed on the challenges of providing effective care. Reported challenges included problems in care homes (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), limited awareness or knowledge among clinicians (39)(40)(41)(42)(43)(44)(45)(46), inappropriate use of medication (16,36,44,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58), assessment and diagnosis difficulties (32, 39-41, 43-46, 59-62), and negative experiences reported by PLwD or MCI and their carers (31,34,41,57,(63)(64)(65)(66)(67)(68)(69)(70)…”

How do care home staff use non-pharmacological strategies to manage sleep disturbances in residents with dementia: The SIESTA qualitative study

“…The data could have been impacted by organisational factors in terms of staff hierarchies [ 51 ], prioritisation of care [ 52 ], staffing levels [ 53 ], and the care home provider, all of which could influence the management of sleep disturbances. In the commentary written about our previous paper from the SIESTA study on the impact of sleep disturbances [ 5 ], the authors comment that staff may be less likely to discuss residents who are awake but lying still and quiet, as they may miss that these residents are awake during their hourly observations. Furthermore, they also comment that the SIESTA study would have been strengthened by measuring sleep disturbances in the residents to see if staff were more likely to discuss those who were awake and disruptive than those who lay awake still and quietly.…”

“…With sleep disturbances often having a negative impact on residents, and as there are currently no safe, efficacious and implementable treatments, future research needs to focus on developing and implementing suitable and efficacious nonpharmacological treatments [ 55 ]. Appropriate management strategies may also help reduce the distress these disturbances can cause for staff themselves, and other residents, reducing the broader impact [ 4 , 5 ]. In the daytime, ways to reduce or stop napping would also be an important element for the management of sleep disturbances, by encouraging residents to do more activity and feel mentally stimulated during times of the day when they are more likely to nap, for example in the afternoon after eating lunch.…”

“…Sleep disturbances can negatively impact the residents who experience them, other residents who are disturbed, and care home staff [ 1 , 3 , 4 ]. They are therefore a priority for treatment [ 5 ], but there is currently a lack of evidence for potential treatments [ 6 ]. Hypnotic medications are a class of medication commonly used to manage sleep disturbances, and there are no randomised controlled trials of hypnotics in people living with dementia so their efficacy is unclear [ 7 ].…”