Document Detail


Nighttime insomnia treatment and education for Alzheimer's disease: a randomized, controlled trial.
MedLine Citation:
PMID:  15877554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate whether a comprehensive sleep education program (Nighttime Insomnia Treatment and Education for Alzheimer's Disease (NITE-AD)) could improve sleep in dementia patients living at home with their family caregivers. DESIGN: A randomized, controlled trial. PARTICIPANTS: Thirty-six community-dwelling patients with Alzheimer's disease (AD) and their family caregivers. INTERVENTION: All participants received written materials describing age- and dementia-related changes in sleep and standard principles of good sleep hygiene. Caregivers in active treatment (n=17) received specific recommendations about setting up and implementing a sleep hygiene program for the dementia patient and training in behavior management skills. Patients in active treatment were also instructed to walk daily and increase daytime light exposure with the use of a light box. Control subjects (n=19) received general dementia education and caregiver support. MEASUREMENTS: Primary sleep outcomes were derived for patients and caregivers from 1 week of sleep-wake activity measured at baseline, posttest (2 months), and 6-month follow-up using an Actillume wrist-movement recorder. Secondary patient outcomes included the Epworth Sleepiness Scale, the Cornell Depression Scale, and the Revised Memory and Behavior Problem Checklist. Caregiver self-reports included the Pittsburgh Sleep Quality Index and the Center for Epidemiological Study of Depression Scale. RESULTS: Patients participating in NITE-AD showed significantly greater (P<.05) posttest reductions in number of nighttime awakenings, total time awake at night, and depression, and increases in weekly exercise days than control subjects. At 6-month follow-up, treatment gains were maintained, and additional significant improvements in duration of night awakenings emerged. When cognitive level was controlled, NITE-AD patients had lower longitudinal ratings of daytime sleepiness than controls. There was a trend for control subjects to spend more time in bed at 6 months than NITE-AD patients. CONCLUSION: This study provides the first evidence that patients with AD who are experiencing sleep problems can benefit from behavioral techniques (specifically, sleep hygiene education, daily walking, and increased light exposure) that are known to improve sleep in nondemented, institutionalized older adults.
Authors:
Susan M McCurry; Laura E Gibbons; Rebecca G Logsdon; Michael V Vitiello; Linda Teri
Related Documents :
448384 - Dopamine receptors and sleep induction in man.
18840034 - Sleep disturbances in patients with schizophrenia : impact and effect of antipsychotics.
17053484 - Good sleep, bad sleep! the role of daytime naps in healthy adults.
11820554 - The effect of individualized activities on the sleep of nursing home residents who are ...
24110814 - Robust sleep apnea monitoring using heart rate variability and extended kalman classifi...
17021184 - Neuronal activity of histaminergic tuberomammillary neurons during wake-sleep states in...
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  53     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-09     Completed Date:  2005-06-21     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-802     Citation Subset:  IM    
Affiliation:
Department of Psychosocial and Community Health, University of Washington, Seattle, Washington 98115, USA. smccurry@u.washington.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Alzheimer Disease / complications,  therapy*
Caregivers / education*
Female
Humans
Male
Middle Aged
Sleep Initiation and Maintenance Disorders / etiology,  psychology,  therapy*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
AG13757/AG/NIA NIH HHS; MH01158/MH/NIMH NIH HHS; MH01644/MH/NIMH NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effect of surgical and nonsurgical treatment on longitudinal outcomes of lumbar spinal stenosis ...
Next Document:  Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake pat...