Gill Livingston, MBChB, MD: Challenges of Sleep Difficulties in People Living with Dementia

“I think the things that are really about to make a difference at the moment are the individualized consideration of somebody’s symptoms and how you can help them, help their sleep, help the carer from being depressed and anxious. All these things vastly improve people’s lives.”

At the 2018 Alzheimer’s Association International Conference in Chicago, Illinois, Gill Livingston, MBChB, MD, Professor of Older Age Psychiatry at University College London, sat down with NeurologyLive to speak to a number of topics in the dementia space.

Livingston began by discussing the results she presented from a randomized controlled trial of a manual based intervention for sleep difficulties in people living with dementia. The trial, Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS-START), was conducted to test the feasibility and acceptability of a co-produced 6-session intervention. Results concluded that the intervention group had generally better secondary efficacy outcome scores on validated outcome measures. The preliminary evidence suggests efficacy, which warrants a full trial examining a manual-based psychological treatment for sleep disorders in dementia. The study results may help to improve outcomes for individuals with dementia, as well as the carers whose sleep is also affected.

She also spoke to the one of the challenges that clinicians face when treating individuals with dementia: dementia is very different for different individuals. Livingston adds that while most patients lose their memory, others have greater neuropsychiatric symptoms like difficulty sleeping, aggression and agitation, which not only affect the patients but also families and caregivers.

Livingston stresses that currently, individualized consideration of someone’s symptoms can be a temporary solution to improving patient’s lives. She sees hope for the future in the fact that change in lifestyle decreases the rate of dementia, which shows that things could get much better, or perhaps worse depending on public health and the population.