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Sleep disturbances in people with dementia living in care homes: measurement, prevalence, manifestation, causes, impact, and persistence

Webster, Lucy Anne; (2021) Sleep disturbances in people with dementia living in care homes: measurement, prevalence, manifestation, causes, impact, and persistence. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Background :Sleep disturbances are common in people living with dementia and maybe the reason they move into a care home. A third of people with dementia in the UK live in care homes. However, there is little research into the prevalence, causes and impacts of sleep disturbances in this population, and this has practical implications on if and how these disturbances should be treated. / Aim: I aimed to investigate measurement, prevalence, manifestation, causes, impact, and persistence of sleep disturbances in people with dementia living in care homes. / Methods: I conducted a meta-analysis on the measurement and prevalence of sleep disturbances and qualitatively interviewed care home staff about their experiences of sleep disturbances in residents with dementia. Lastly, I investigated the manifestation, persistence and impact of sleep disturbances using the MARQUE (Managing Agitation and Raising QUality of lifE) cohort study; data collected from 1483 residents with dementia for 16 months. / Results: In my meta-analyses, the prevalence of sleep disturbances on validated questionnaires was 38% for symptoms and 20% for clinically significant cases. On actigraphy, 70% had sleep disturbance and staff described how sleep disturbances negatively impacted residents with dementia, staff and other residents. In MARQUE, half of the residents had symptoms of sleep disturbance at one-time point of the study, often getting up at night-time and daytime sleepiness. Of those who had symptoms of sleep disturbance at baseline, the disturbance mostly fluctuated (47%) or persisted (25%) across the study. Having sleep disturbances longitudinally negatively impacted residents’ quality of life (regression coefficient -3.94, 95% confident intervals -4.82 to -3.06), and those with clinically significant cases were more likely to have hospital admissions. There was no correlation between sleep disturbances and mortality. / Conclusion: Sleep disturbances in residents with dementia are common, often fluctuate or persist, and negatively impact their quality of life and are therefore a priority for treatment.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Sleep disturbances in people with dementia living in care homes: measurement, prevalence, manifestation, causes, impact, and persistence
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
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
URI: https://discovery.ucl.ac.uk/id/eprint/10119727
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