Dementia, which can stem from a variety of diseases, impacts memory, thinking, and how a person is able to perform daily activities (1). It is estimated that about 1 in 4 adults aged 85+ have been diagnosed with dementia in Canada (2). For people living with dementia, experiencing problems with sleep can be all too common. This can be highly stressful not only for the individual, but also their carers.
Difficulty sleeping can transcend into worsening wandering, cognitive issues, restlessness, and accidental falls (3).
There continues to be a lack of evidence supporting the use of medications to address sleep problems for people living with dementia (3;4). This has led researchers to investigate non-drug options that might be helpful in reducing or preventing sleep disturbances. A recent systematic review comparing non-drug options to usual care, mostly in nursing homes, sheds light on this very topic (3).
What the research tells us
The non-drug methods evaluated in the review include a wide range of strategies, such as: light exposure programs like light therapy, physical activities like walking and leg and arm exercises, social activities like talking with others, slow-stroke back massage, transcranial electrostimulation involving the use of electrodes on a headband to deliver electric pulses to the brain, approaches including carers like carer training on how to execute non-drug strategies, and multi-component strategies.
Low certainty evidence found that physical activities, social activities, approaches that involve carers, and multi-component strategies may help improve sleep by slight to moderate amounts in people living with dementia compared to usual care. There is uncertainty on whether the other non-drug options looked at are helpful for sleep problems. More high-quality studies are needed to better understand the effectiveness of these non-drug strategies and how they compare to one another.
Even with the need for more research, the review still encourages healthcare professionals to opt for non-drug options as a first line of treatment for sleep issues in dementia. This is because drug therapies may come with more risks and the currently available evidence does not clearly show that they are better than non-drug options (3). If you are a carer for a person with dementia experiencing sleep problems, you may want to discuss non-drug options with your loved one as well as their healthcare team.
