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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 ,
Jonas Hylla ,
Almuth Berg ,
Gabriele Meyer ,
Sascha Köpke ,
Margareta Halek ,
Ralph Möhler  and
Martin N. Dichter
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.
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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.

Keywords

nursing homelong-term caremulticomponent interventionspsychosocial interventionsnursing researchsystematic review
Type
Review Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 3: Issue Theme: Neuropsychiatric Symptoms in Older Adults with Cognitive Disorders , March 2021 , pp. 245 - 273
Copyright
© International Psychogeriatric Association 2020

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