Behavioral Intervention Improves Sleep in Alzheimer's Patients

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Patients with Alzheimer's disease (AD) often are affectedby both daytime and nighttime sleep disturbances.Nocturnal sleep disturbances can increase physical and psychologicalmorbidity and increase the risk of having to institutionalizethe patient.

The results of a recent randomized, controlled study(Nighttime Insomnia Treatment and Education for Alzheimer'sDisease [NITE-AD]) were reported in the Journal of the AmericanGeriatrics Society (May 2005). NITE-AD evaluated whether acomprehensive sleep education program could improve sleepin patients with dementia living at home with their family caregivers.The intervention, which was directed at both thepatients and their caregivers, was an educational program onthe standard principles of good sleep hygiene. Caregivers weregiven specific instructions in behavior management and howto implement the sleep hygiene program. Patients wereinstructed to walk daily and to increase daytime light exposurewith the use of a light box. The control group received generaldementia education and caregiver support.

Patients in the active group showed significant (P <.05)reductions in the number of nighttime awakenings, total timeawake at night, and clinician-measured depression, comparedwith the control group. The study provided the first evidencethat patients with AD who experience sleep problems can benefitfrom the same behavioral interventions that are known toimprove sleep in patients without dementia.

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