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Characteristics of multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents: a systematic review

Published online by Cambridge University Press:  05 June 2020

Denise Wilfling
Affiliation:
Institute of Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
Jonas Hylla
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Almuth Berg
Affiliation:
Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
Gabriele Meyer
Affiliation:
Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
Sascha Köpke
Affiliation:
Institute of Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany Institute of Nursing Science, Medical Faculty, University of Cologne, Cologne, Germany
Margareta Halek
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Ralph Möhler
Affiliation:
School of Public Health, Bielefeld University, Bielefeld, Germany
Martin N. Dichter*
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany Institute of Nursing Science, Medical Faculty, University of Cologne, Cologne, Germany
*
Correspondence should be addressed to: Martin N. Dichter, German Center for Neurodegenerative Diseases (DZNE), Witten, Germany; School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany; and Institute of Clinical Nursing Science, Medical Faculty, University of Cologne, Cologne, Germany. Phone: +49 221 478 34640; Fax: +49 221 478-85931. Email: Martin.Dichter@uk-koeln.de.

Abstract

Background:

Dementia guidelines propose the use of nonpharmacological interventions for sleep disturbances for older people. Based on available reviews, it seems most likely that multicomponent interventions have the strongest potential to be effective in improving sleep. However, a detailed description of multicomponent interventions is missing. This systematic review aims to identify, describe, and summarize multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents.

Methods:

This review followed established methodological frameworks for systematic evidence syntheses. A computerized search was conducted in December 2018, using the databases PubMed, CINAHL, Scopus, and Cochrane Library. Two independent reviewers assessed all search results to identify eligible studies and assessed studies’ methodological quality following the Cochrane Risk of Bias methodology for randomized controlled trials and the CASP Appraisal Checklist for controlled trials.

Evaluation studies of any design investigating multicomponent interventions were included, except case studies. Components of included intervention programs were analyzed applying the TIDieR and CReDECI 2 criteria.

Results:

A total of 2056 studies were identified through the database search; ten publications about nine interventions met the inclusion criteria and were included in the review. The identified interventions can be summarized assigned to the categories “daytime activities,” “nighttime activities,” “staff training,” and “light exposure.” The approaches showed similarities and differences in procedures, materials, modes of delivery, intervention provider, and intervention period. None of the studies described any intended interactions between components or considered context characteristics in intervention modeling as well as internal and external facilitators or barriers influencing delivery of intervention. We identified positive or mixed positive effects for sleep-related outcomes for the mentioned categories.

Conclusions:

The analysis of included interventions demonstrates somehow promising results, although findings are difficult to interpret as interventions were not well described, and the challenges of developing and evaluating complex interventions were not sufficiently acknowledged.

Type
Review Article
Copyright
© International Psychogeriatric Association 2020

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References

Aasmul, I., Husebo, B.S. and Flo, E. (2016). Staff distress improves by treating pain in nursing home patients with dementia: results from a cluster-randomized controlled trial. Journal of Pain and Symptom Management, 52, 795805.CrossRefGoogle ScholarPubMed
Alessi, C.A. et al. (2005). Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. Journal of the American Geriatrics Society, 53, 803810.CrossRefGoogle ScholarPubMed
Alessi, C.A. and Schnelle, J.F. (2000). Approach to sleep disorders in the nursing home setting. Review article. Sleep Medicine Reviews, 4, 4556.CrossRefGoogle ScholarPubMed
Alessi, C.A., Yoon, E.J., Schnelle, J.F., Al-Samarrai, N.R. and Cruise, P.A. (1999). A randomized trial of a combined physical activity and environmental intervention in nursing home residents: do sleep and agitation improve? Journal of American Geriatrics Society, 47, 784791.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S. et al. (2003). Increased light exposure consolidates sleep and strengthens circadian rhythms in severe Alzheimer’s disease patients. Behavioral Sleep Medicine, 1, 2236.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S., Martin, J.L., Kripke, D.F., Marler, M. and Klauber, M.R. (2002). Effect of light treatment on sleep and circadian rhythms in demented nursing home patients. Journal of American Geriatrics Society, 50, 282289.CrossRefGoogle ScholarPubMed
Bernabei, R., Landi, F. and Sgadari, A. (1996). Minimum Data Set for Nursing Home. MDSNH. Manuale di istruzione. Roma: Pfizer Italia SpA.Google Scholar
Bird, M., Anderson, K., Macpherson, S. and Blair, A. (2016). Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence. International Psychogeriatrics, 28, 19371963.CrossRefGoogle ScholarPubMed
Bliwise, D. and Breus, M. (2000). Insomnia in dementia and in residential care. In: Lichtstein, K.L. and Morin, C.M. (Eds.), Treatment of Late-Life Insomnia. Sage Publishing.Google Scholar
Boersma, P., Van Weert, J.C., Van Meijel, B. and Droes, R.M. (2017). Implementation of the Veder contact method in daily nursing home care for people with dementia: a process analysis according to the RE-AIM framework. Journal of Clinical Nursing, 26, 436455.CrossRefGoogle ScholarPubMed
Buysse, D.J., Reynolds, C.F., 3rd, Monk, T.H., Berman, S.R. and Kupfer, D.J. (1989). The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193213.CrossRefGoogle ScholarPubMed
Capezuti, E. et al. (2018). A systematic review of non-pharmacological interventions to improve nighttime sleep among residents of long-term care settings. BMC Geriatrics, 18, 143.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Thein, K., Marx, M.S. and Dakheel-Ali, M. (2012). What are the barriers to performing nonpharmacological interventions for behavioral symptoms in the nursing home? JAMDA, 13, 400405.Google ScholarPubMed
Craig, P. et al. (2013). Developing and evaluating complex interventions: the new medical research council guidance. International Journal of Nursing Studies, 50, 587592.CrossRefGoogle ScholarPubMed
Critical Appraisal Skills Programme. (2019). CASP checklist [Online]. Available at http://casp-uk.net; last accessed 8 September 2019.Google Scholar
Cruise, P.A., Schnelle, J.F., Alessi, C.A., Simmons, S.F. and Ouslander, J.G. (1998). The nighttime environment and incontinence care practices in nursing homes. Journal of American Geriatrics Society, 46, 181186.CrossRefGoogle ScholarPubMed
Deuschl, G. and Maier, W. (2016). S3-Leitlinie Demenzen. Leitlinien für Diagnostik und Therapie in der Neurologie. Berlin: Deutsche Gesellschaft für Neurologie.Google Scholar
Dowling, G.A. et al. (2005). Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer’s disease. International Psychogeriatrics, 17, 221236.CrossRefGoogle ScholarPubMed
Foley, D.J., Monjan, A., Simonsick, E.M., Wallace, R.B. and Blazer, D.G. (1999). Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep, 22(Suppl 2), S366S372.Google ScholarPubMed
Frohnhofen, H., Fulda, S., Frohnhofen, K. and Popp, R. (2013). Validation of the essener questionnaire of age and sleepiness in the elderly using pupillometry. Advances in Experimental Medicine and Biology, 755, 125132.CrossRefGoogle ScholarPubMed
Fung, C.H. et al. (2016). Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Sleep, Circadian rhythms, and aging: new avenues for improving brain health, physical health, and functioning. Journal of American Geriatrics Society, 64, e238e247.CrossRefGoogle Scholar
Gattinger, H., Hantikainen, V., Ott, S. and Stark, M. (2017). Effectiveness of a mobility monitoring system included in the nursing care process in order to enhance the sleep quality of nursing home residents with cognitive impairment. Health Technology, 7, 161171.CrossRefGoogle Scholar
Gibson, R.H., Gander, P.H. and Jones, L.M. (2014). Understanding the sleep problems of people with dementia and their family caregivers. Dementia (London), 13, 350365.CrossRefGoogle ScholarPubMed
Herrmann, W.J. and Flick, U. (2012). External barriers to good sleep from the nursing home residents’ perspective. Pflege Zeitschrift, 65, 744748.Google ScholarPubMed
Higgins, J.P. et al. (2011). The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343, d5928.CrossRefGoogle ScholarPubMed
Hoffmann, T.C., et al. (2014). Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ, 348, g1687.CrossRefGoogle ScholarPubMed
Kovach, C.R., Evans, C.R., Sattell, L., Rosenau, K. and Gopalakrishnan, S. (2018). Feasibility and pilot testing of a mindfulness intervention for frail older adults and individuals with dementia. Research in Gerontological Nursing, 11, 137150.CrossRefGoogle ScholarPubMed
Kuck, J., Pantke, M. and Flick, U. (2014). Effects of social activation and physical mobilization on sleep in nursing home residents. Geriatric Nursing, 35, 455461.CrossRefGoogle ScholarPubMed
Lee, J.H. et al. (2007). Daytime sleepiness and functional impairment in Alzheimer disease. American Journal of Geriatric Psychiatry, 15, 620626.CrossRefGoogle ScholarPubMed
Li, J., Grandner, M.A., Chang, Y.P., Jungquist, C. and Porock, D. (2017). Person-centered dementia care and sleep in assisted living residents with dementia: a pilot study. Behavioral Sleep Medicine, 15, 97113.CrossRefGoogle ScholarPubMed
Liberati, A. et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of Clinical Epidemiology, 62, e1e34. doi: 10.1016/j.jclinepi.2009.06.006.CrossRefGoogle ScholarPubMed
Martin, J.L., Marler, M.R., Harker, J.O., Josephson, K.R. and Alessi, C.A. (2007). A multicomponent nonpharmacological intervention improves activity rhythms among nursing home residents with disrupted sleep/wake patterns. Journal of Gerontology Series A Biological Sciences and Medical Sciences, 62, 6772.CrossRefGoogle ScholarPubMed
McCleery, J., Cohen, D.A. and Sharpley, A.L. (2014). Pharmacotherapies for sleep disturbances in Alzheimer’s disease. Cochrane Database of Systematic Reviews, 11, CD009178.Google Scholar
McCurry, S.M., Gibbons, L.E., Logsdon, R.G., Vitiello, M.V. and Teri, L. (2005). Nighttime insomnia treatment and education for Alzheimer’s disease: a randomized, controlled trial. Journal of American Geriatrics Society, 53, 793802.CrossRefGoogle ScholarPubMed
McCurry, S.M., Lafazia, D.M., Pike, K.C., Logsdon, R.G. and Teri, L. (2012). Development and evaluation of a sleep education program for older adults with dementia living in adult family homes. American Journal of Geriatric Psychiatry, 20, 494504.CrossRefGoogle ScholarPubMed
McCurry, S.M. et al. (2011). Increasing walking and bright light exposure to improve sleep in community-dwelling persons with Alzheimer’s disease: results of a randomized, controlled trial. Journal of American Geriatrics Society, 59, 1393–402.CrossRefGoogle Scholar
McPherson, S., Hiskey, S. and Alderson, Z. (2016). Distress in working on dementia wards – a threat to compassionate care: a grounded theory study. International Journal of Nursing Studies, 53, 95104.CrossRefGoogle ScholarPubMed
Möhler, R., Köpke, S. and Meyer, G. (2015). Criteria for reporting the development and evaluation of complex interventions in healthcare: revised guideline (CReDECI 2). Trials, 16, 204.CrossRefGoogle Scholar
Moore, G.F. et al. (2015). Process evaluation of complex interventions: medical research council guidance. BMJ, 350, h1258.CrossRefGoogle ScholarPubMed
Morin, C.M. (1993). Insomnia: Psychological Assessment and Management. New York: Guilford Press.Google Scholar
National Institute for Health and Care Excellence. (2018). Dementia: assessment, management and support for people living with dementia and their carers [Online]. Available at https://www.nice.org.uk/guidance/NG97; last accessed 1 September 2019.Google Scholar
Ouslander, J.G. et al. (2006). A nonpharmacological intervention to improve sleep in nursing home patients: results of a controlled clinical trial. Journal of American Geriatrics Society, 54, 3847.CrossRefGoogle ScholarPubMed
Ouzzani, M., Hammady, H., Fedorowicz, Z. and Elmagarmid, A. (2016). Rayyan-a web and mobile app for systematic reviews. Systematic Reviews, 5, 210.CrossRefGoogle ScholarPubMed
Quasdorf, T. et al. (2017). Implementing dementia care mapping to develop person-centred care: results of a process evaluation within the Leben-QD II trial. Journal of Clinical Nursing, 26, 751765.CrossRefGoogle ScholarPubMed
Rapaport, P., Livingston, G., Murray, J., Mulla, A. and Cooper, C. (2017). Systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia. BMJ Open, 7, e014177.CrossRefGoogle ScholarPubMed
Richards, K.C. et al. (2011). Strength training, walking, and social activity improve sleep in nursing home and assisted living residents: randomized controlled trial. Journal of American Geriatrics Society, 59, 214223.CrossRefGoogle ScholarPubMed
Richter, T., Mann, E., Meyer, G., Haastert, B. and Köpke, S. (2012). Prevalence of psychotropic medication use among German and Austrian nursing home residents: a comparison of 3 cohorts. Journal of American Medical Directors Association, 13, 187 e7e187 e13.CrossRefGoogle ScholarPubMed
Schmidt, S.G., Dichter, M.N., Palm, R., Müller, B.H. and Hasselhorn, H.M. (2012). Distress experienced by nurses in response to the challenging behaviour of residents – evidence from German nursing homes. Journal of Clinical Nursing, 21, 31343142.CrossRefGoogle ScholarPubMed
Schnelle, J.F., Alessi, C.A., Al-Samarrai, N.R., Fricker, R.D. Jr. and Ouslander, J.G. (1999). The nursing home at night: effects of an intervention on noise, light, and sleep. Journal of American Geriatrics Society, 47, 430438.CrossRefGoogle ScholarPubMed
Schnelle, J.F. et al. (1998). Sleep hygiene in physically dependent nursing home residents: behavioral and environmental intervention implications. Sleep, 21, 515523.Google ScholarPubMed
Sloane, P.D., Zimmerman, S., Brown, L.C., Ives, T.J. and Walsh, J.F. (2002). Inappropriate medication prescribing in residential care/assisted living facilities. Journal of American Geriatrics Society, 50, 10011011.CrossRefGoogle ScholarPubMed
Van Der Ploeg, E.S. and O’connor, D.W. (2014). Methodological challenges in studies of bright light therapy to treat sleep disorders in nursing home residents with dementia. Psychiatry and Clinical Neurosciences, 68, 777784.CrossRefGoogle ScholarPubMed
Wilfling, D., Dichter, M.N., Trutschel, D. and Köpke, S. (2019). Prevalence of sleep disturbances in german nursing home residents with dementia: a multicenter cross-sectional study. Journal of Alzheimers Disease, 69, 227236.CrossRefGoogle Scholar
Wilfling, D. et al. (2015). Non-pharmacological interventions for sleep disturbances in people with dementia (Protocol). Cochrane Database of Systematic Reviews, doi: 10.1002/14651858.CD011881.CrossRefGoogle Scholar
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