4.4 Article

Development of a dyadic sleep intervention for Alzheimer's disease patients and their caregivers

Journal

DISABILITY AND REHABILITATION
Volume 43, Issue 13, Pages 1861-1871

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2019.1680748

Keywords

Behavioral sleep intervention; Alzheimer's disease; family caregiver; dyadic approach

Categories

Funding

  1. National Institute on Aging [K23AG055668, K23AG045937]
  2. National Institute on Aging [Beeson Career Development in Aging Research Award Program]
  3. National Heart Lung and Blood Institute of the National Institutes of Health [K24HL143055]
  4. VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center (GRECC)

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This study successfully refined a behavioral sleep intervention program for patients with Alzheimer's disease and their caregivers through an iterative process, resulting in evidence of sleep improvements. Multiple revisions were made during testing, with adjustments to the structure and materials based on feedback from caregivers and sleep educators, ultimately achieving the desired outcomes.
Purpose: This study aimed to refine a behavioral sleep intervention program targeting patients with Alzheimer's disease and their caregivers. Methods: In this case series, key components of the sleep program were built upon previous intervention studies of patients with cognitive impairment/dementia. The intervention consisted of five weekly sessions covering sleep hygiene, sleep compression, stimulus control, daily walking/light exposure, relaxation/mindfulness, and caregiver training to manage patients' behavioral problems. The materials and structure were iteratively refined based on feedback from caregivers and sleep educators. Sleep diaries were used to evaluate sleep outcomes. Results: Five out of six enrolled dyads completed the sessions. Several revisions were made during testing: the last session was changed from telephone to in-person; some components (e.g., sleep scheduling, mindfulness) were rearranged within or across sessions; sleep educator guidelines for sleep scheduling, light exposure, and walking were revised. After the fifth dyad, no additional issues were identified by the caregiver or the sleep educator. Four patients and three caregivers had improved sleep at the last session. Conclusions: The iterative refinement process was successful in finalizing the intervention program, with evidence of sleep improvements. Formal pilot testing of the program will provide further information on feasibility and effectiveness.

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