The management of sleep disorders in dementia: an update.
Study Goal
The researchers aimed to evaluate the effectiveness of light therapy for managing sleep disturbances in people with dementia.
Results Summary
The study found no effect of light therapy on sleep disturbances in dementia patients, aligning with previous Cochrane reviews that reported no proven effectiveness for this intervention.
Population
People with dementia living in the community.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
light therapy | no change | sleep disorders in dementia | people with dementia | no effect | no effect | #1 |
melatonin | no change | sleep disorders in dementia | people with dementia | ineffective | ineffective | #2 |
melatonin | neutral | sleep disturbances | people with dementia living at home | - | - | #3 |
psychotropic medications | neutral | sleep disturbances | people with dementia living at home | - | - | #4 |
donepezil | neutral | sleep disturbances | people with dementia living at home | - | - | #5 |
memantine | neutral | sleep disturbances | people with dementia living at home | - | - | #6 |
nonpharmacological interventions | neutral | sleep disturbances in dementia | people with dementia | - | preliminary work | #7 |
PURPOSE OF REVIEW: Sleep disorders in dementia cause distress and may lead to families being unable to care for someone with dementia at home. Recent Cochrane reviews found no interventions of proven effectiveness. There was no effect of light therapy and moderate evidence that melatonin was ineffective both given without knowledge of the patient's circadian rhythm. The current article updates this review by considering newer publications on interventions for sleep disorders or abnormalities of the sleep-wake cycle in people with dementia living in the community. RECENT FINDINGS: We searched electronically for new primary research, reviews and meta-analyses and identified 258 articles published between 15/12/2015 and 14/06/2017 on sleep and dementia; 43 of them on nonpharmacological or pharmacological treatments. Fifteen articles reported on the management of sleep disturbances in people with dementia, living at home. Those using pharmacological treatments (melatonin, psychotropic medications, donepezil, memantine) encompassed a meta-analysis, two double-blind RCTs, two uncontrolled trials, two population-based studies, and one case report. The studies of behavioural interventions comprised five uncontrolled trials, one case series, and one qualitative study. We also included three recent reviews on the management of sleep disturbances in Alzheimer's disease; pharmacotherapies for sleep disturbances in dementia, and dementia prevention, intervention and care. None of these found a treatment that showed definitive effectiveness, although there is preliminary work about nonpharmacological interventions, which can be built on. SUMMARY: Clinically effective, safe treatment of sleep disturbances in dementia remains an unresolved challenge. Given the importance of sleep and the many consequences of its disruption, well designed controlled trials are needed to determine acceptable and cost-effective treatment strategies that work for sleep disturbances.