Patients with Alzheimer's disease (AD) often are affected by both daytime and nighttime sleep disturbances. Nocturnal sleep disturbances can increase physical and psychological morbidity and increase the risk of having to institutionalize the patient.
The results of a recent randomized, controlled study (Nighttime Insomnia Treatment and Education for Alzheimer's Disease [NITE-AD]) were reported in the Journal of the American Geriatrics Society (May 2005). NITE-AD evaluated whether a comprehensive sleep education program could improve sleep in patients with dementia living at home with their family caregivers. The intervention, which was directed at both the patients and their caregivers, was an educational program on the standard principles of good sleep hygiene. Caregivers were given specific instructions in behavior management and how to implement the sleep hygiene program. Patients were instructed to walk daily and to increase daytime light exposure with the use of a light box. The control group received general dementia education and caregiver support.
Patients in the active group showed significant (P <.05) reductions in the number of nighttime awakenings, total time awake at night, and clinician-measured depression, compared with the control group. The study provided the first evidence that patients with AD who experience sleep problems can benefit from the same behavioral interventions that are known to improve sleep in patients without dementia.