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Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis

Webster, L; Costafreda Gonzalez, S; Stringer, A; Lineham, A; Budgett, J; Kyle, S; Barber, J; (2019) Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis. Sleep 10.1093/sleep/zsz251. (In press). Green open access

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Abstract

STUDY OBJECTIVES: Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness, and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia. // METHODS: We searched Embase, MEDLINE, and PsycINFO (29/04/2019) for studies of the prevalence or associated factors of sleep disturbances in people with dementia living in care homes. We computed meta-analytical estimates of the prevalence of sleep disturbances and used meta-regression to investigate effects of method of measurement, demographics and study characteristics. // RESULTS: We included 55 studies of 22,780 participants. The pooled prevalence on validated questionnaires of clinically significant sleep disturbances was 20% (95% Confidence Interval, CI 16-24%) and of any symptom of sleep disturbance was 38% (95% CI 33%-44%). On actigraphy using a cut-off of sleep efficiency <85% prevalence was 70% (95% CI 55-85%). Staff distress, resident agitation and prescription of psychotropic medications were associated with sleep disturbances. Studies with a higher percentage of males had a higher prevalence of sleep disturbance. // CONCLUSION: Clinically significant sleep disturbances are less common than those measured on actigraphy, and are associated with residents and staff distress, and increased prescription of psychotropics. Actigraphy appears to offer no benefit over proxy reports in this population.

Type: Article
Title: Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/sleep/zsz251
Publisher version: https://doi.org/10.1093/sleep/zsz251
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Actigraphy, Aging, Dementia, Insomnia
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10084208
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