Gill Livingston, MBChB, MD: Manual Based Intervention for Sleep Difficulties in Dementia

“One of the challenging things about dementia, is that it's so different between different individuals."

At the 2018 Alzheimer’s Association International Conference held in Chicago, Illinois, Gill Livingston, MBChb, MD, Professor at the University College London, sat with NeurologyLive to discuss the results of a manual-based intervention for sleep disturbance in individuals with dementia: Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS-START).

The DREAMS-START trial was conducted to test the feasibility and acceptability of a co-produced 6-session manual-based intervention. Eligible participants for the single-blind, randomized trial, were those with dementia and sleep disturbances, scoring ≥4 on at least one Sleep Disorders Inventory item, which either the individual with dementia or the caregiver found a problem; and having a family caregiver. Study participants were randomly allocated to 1 of the 2 groups. The first group received treatment as usual, while those in the second group received treatment as usual and were taking part in 6, hour-long weekly sessions of the program. All participants were asked to wear an actiwatch prior to randomization for 2 weeks, then again 3 months later in order to compare sleep patterns. Caregivers completed questionnaires asking about the sleep, behavior, mood and quality of life patterns the individual with dementia endures, as well as about the carer’s own sleep, mood and quality of life at the start of the study and after 3 months.

Results concluded that the intervention group had better secondary efficacy outcome scores on the validated outcome measures versus the arm receiving treatment as usual.

DREAMS-START demonstrates that a manual-based psychological treatment for sleep disorders in those living with dementia is feasible and acceptable, and a full trial is warranted to confirm the preliminary evidence.