Related Experiment Video
Updated: Jun 6, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
The effectiveness of a cognitive behavioural therapy for insomnia based intervention to improve sleep quality in
Hilde Lahaye1, Filip Haegdorens2, Erik Franck2
1Research Group Health for Older People (HOPE), Odisee University College, Hospitaalstraat 23, 9100, Sint‑Niklaas, Belgium. hilde.lahaye@odisee.be.
Purpose:
To evaluate the effectiveness of a structured, team-delivered intervention based on cognitive behavioural therapy for insomnia (CBT-I) on sleep and related outcomes in nursing home residents.
Methods:
A cluster randomised controlled trial with intervention group and control group was conducted in five nursing homes between February 2024 and February 2025. A total of 240 residents were included, with a mean age of 86.8 years and 72.5% being female. Sleep outcomes were assessed using the Pittsburgh Sleep Quality Index (PSQI) for residents who were cognitively intact or mildly impaired, and the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) for residents with significant cognitive or language impairments.
Results:
In the PSQI group (n = 124) there was a significant interaction effect between time and group for the total PSQI score (p = 0.031). No significant between-group difference was observed at follow-up. In the NPI-NH group (n = 116), no significant effect was found for sleep and nighttime behaviour disturbances (p = 0.061). However, residents in the intervention group showed significant improvements across several neuropsychiatric domains, including reductions in delusions, agitation/aggression, depression, disinhibition and aberrant motor behaviour.
Conclusion:
Although the intervention did not result in significant between-group differences in sleep outcomes, these findings suggest that a structured, team-delivered CBT-I-based intervention may contribute to improvements in behavioural and psychological symptoms of dementia (BPSD). This underscores the often-overlooked relationship between sleep and BPSD and supports further investigation of team-based sleep interventions in long-term care settings.
Trial Registration:
ISRCTN50844606, registered on 9 September 2024.
Related Concept Videos
Management of Insomnia
Insomnia
Multiple factors contribute...
Nursing Interventions II: Selecting and Classifying the Nursing Interventions
Blind Procedures
Nursing Evaluation
Section...
Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...