Timed Activity to Minimize Sleep Disturbance in People With Cognitive Impairment

Area of Science:

• Gerontology
• Sleep Medicine
• Neuroscience

Background:

• Sleep disturbances affect over 60% of individuals with cognitive impairment, significantly impacting their quality of life (QOL).
• Nonpharmacological interventions, such as timed cognitive, physical, and sensory activities, show promise for managing sleep problems.
• The Healthy Patterns Sleep Program was developed to address sleep disturbances and improve QOL in this population.

Purpose of the Study:

• To evaluate the efficacy of the Healthy Patterns Sleep Program, a timed-activity intervention, in improving QOL and sleep disturbances.
• To assess the impact of the intervention on objective and subjective sleep quality, and neuropsychiatric symptoms.
• To identify subgroups that may particularly benefit from the intervention.

Main Methods:

• A randomized controlled trial with 209 dyads of community-residing persons with cognitive impairment and their care partners.
• Participants were assigned to either the Healthy Patterns Sleep Program (weekly 1-hour sessions over 4 weeks) or an attention-control group (sleep hygiene and health education).
• Assessments included QOL, objective/subjective sleep quality, and neuropsychiatric symptoms at baseline and 4 weeks.

Main Results:

• The intervention group showed a significant improvement in QOL compared to the control group (p=0.0491).
• No significant differences were observed in objective or subjective sleep quality, or neuropsychiatric symptoms between groups.
• Subgroup analysis revealed significant improvements in subjective sleep (PROMIS Sleep-Related Impairment) for those with depressive symptoms (p=0.015) or poor observed sleep at baseline (p=0.005).

Conclusions:

• The Healthy Patterns Intervention may enhance QOL for individuals with cognitive impairment, especially those experiencing poor subjective sleep.
• Further research with longer intervention durations may be needed to demonstrate effects on actigraphy-measured sleep-wake activity.
• Timed-activity interventions represent a potential nonpharmacological approach to improving well-being in individuals with cognitive impairment.