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The management of sleep disorders in dementia: an update.

Current opinion in psychiatry
November 1, 2017
Kirsi M Kinnunen et al. (3 authors)
Journal ArticleReviewHuman Study
Study Details

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

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
DementiaDisease ManagementHumansIndependent LivingNeeds AssessmentSleep HygieneSleep Wake Disorders
Study Links
Quality Scores
SafetyNot Assessed
Efficacy20/10
Quality75/10
Citation Metrics
Total Citations29
Citations/Year3.6
Relative Citation Ratio1.67
NIH Percentile68.8%
Research Impact Scores
APT Score0.75
Weight Score1.97
Normalized Score0.43
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