Effect of individualized social activity on sleep in nursing home residents with dementia

Abstract

Objectives: To test the efficacy of an individualized social activity intervention (ISAI) on decreasing daytime sleep, improving nighttime sleep, and lowering the day/night sleep ratio and to determine its cost.

Design: Pretest/posttest randomized with an experimental and control group.

Setting: Seven nursing homes.

Participants: One hundred forty-seven residents with dementia.

Intervention: One to 2 hours of individualized social activities for 21 consecutive days.

Measurements: Twenty-four-hour sleep/wake patterns using an Actigraph.

Results: The ISAI group had significantly less daytime sleep (P=.001) and a lower day/night sleep ratio (P=.03) than the control group, after adjusting for baseline values. Because 40% of the sample slept 7 or more hours at night, a secondary analysis was conducted. When only those residents with a sleep efficiency of less than 50% (n=50) were included, the ISAI group (n=20) had less daytime sleep (P=.005), a lower day/night sleep ratio (P=.02), fell asleep faster (P=.03), and were awake less at night (P=.04) than the control group (n=30), after adjusting for baseline values. The weekly cost of the ISAI was roughly $70 per participant. Initial training and supply costs were $1,944.

Conclusion: The ISAI provides an alternative to medications, without side effects.