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Intervention for sleep problems in nursing home residents with dementia: a cluster-randomized study

Published online by Cambridge University Press:  08 January 2024

Martin Nikolaus Dichter Open the ORCID record for Martin Nikolaus Dichter [Opens in a new window] ,
Jonas Dörner ,
Denise Wilfling ,
Almuth Berg ,
Thomas Klatt ,
Ralph Möhler ,
Burkhard Haastert ,
Gabriele Meyer ,
Margareta Halek  and
Sascha Köpke
Martin Nikolaus Dichter*
Affiliation:
Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Jonas Dörner
Affiliation:
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Denise Wilfling
Affiliation:
Institute of Social Medicine and Epidemiology, Nursing Research Group, University of Lübeck, Lübeck, Germany
Almuth Berg
Affiliation:
Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
Thomas Klatt
Affiliation:
Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
Ralph Möhler
Affiliation:
Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Burkhard Haastert
Affiliation:
mediStatistica, Neuenrade, Germany
Gabriele Meyer
Affiliation:
Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
Margareta Halek
Affiliation:
School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Sascha Köpke
Affiliation:
Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
*
Correspondence should be addressed to: M. N. Dichter, Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Tel: +49 221-478-34640; Mobil: +49 15142228492; Fax: +49 221 478-85931. Email: [email protected].
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Abstract

Objective:

To reduce sleep problems in people living with dementia using a multi-component intervention.

Design:

Cluster-randomized controlled study with two parallel groups and a follow-up of 16 weeks.

Setting:

Using external concealed randomization, 24 nursing homes (NH) were allocated either to the intervention group (IG, 12 clusters, 126 participants) or the control group (12 clusters, 116 participants).

Participants:

Participants were eligible if they had dementia or severe cognitive impairment, at least two sleep problems, and residence of at least two weeks in a NH.

Intervention:

The 16-week intervention consists of six components: (1) assessment of sleep-promoting activities and environmental factors in NHs, (2) implementation of two “sleep nurses,” (3) basic education, (4) advanced education for staff, (5) workshops to develop sleep-promoting concepts, and (6) written information and education materials. The control group (CG) received standard care.

Measurements:

Primary outcome was ≥ two sleep problems after 16 weeks assessed with the Sleep Disorders Inventory (SDI).

Results:

Twenty-two clusters (IG = 10, CG = 12) with 191 participants completed the study. At baseline, 90% of people living with dementia in the IG and 93% in the CG had at least two sleep problems. After 16 weeks, rates were 59.3% (IG) vs 83.8% (CG), respectively, a difference of −24.5% (95% CI, −46.3% – −2.7%; cluster-adjusted odds ratio 0.281; 95% CI 0.087–0.909). Secondary outcomes showed a significant difference only for SDI scores after eight and 16 weeks.

Conclusions:

The MoNoPol-Sleep intervention reduced sleep problems of people living with dementia in NH compared to standard care.

Keywords

nursing homesdementiasleep problemssleepcomplex interventionsdyssomniasperson-centered care
Type
Original Research Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 10: Issue Theme: Positive Psychiatry of Aging , October 2024 , pp. 965 - 978
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Psychogeriatric Association

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