Up to 90 per cent of people with dementia experience problems with sleep. 

Research aims to improve sleep for people with dementia

Two new research programmes are helping find new ways to support people with dementia who experience problems with sleep.

Across the world, around 55 million people have dementia. Up to 90 per cent of them experience problems sleeping.

Both too much and too little sleep are common, and can have significant impacts on health, leading to falls, or worsening existing symptoms and increasing death rates. Commonly used sleeping tablets can also be particularly harmful to people with dementia.

Two research programmes led by the University of Exeter are now seeking to provide answers to help support better sleep, both for people living at home and in care homes.

The TaIlored ManagEment of Sleep (TIMES) study will develop a tool to help people with dementia and other memory problems, by producing care plans that are tailored to individual needs. Funded with £2.4 million from the National Institute for Health Research (NIHR), the team combines expertise from the universities of Oxford, Hull and Leicester, working with University College London, Aston University, and the University of East Anglia, alongside Innovations in Dementia.

Study lead Professor Chris Fox, from the University of Exeter, said: “Sleep disturbance can have a major impact on daily living for people living with dementia or memory problems, and can make it difficult for carers to cope. Many different factors can upset sleep, so help needs to be tailored to individuals. Medicines help some people, but sleep medicines used long-term can be harmful or stop working. Our study will help people find the best approach for them.”

In care homes, sleep problems in people with dementia are extremely common. Disturbances can lead to poorer quality of life, worsening dementia and loss of opportunities for eating and socialising during the day. They can also cause distress to other residents and place considerable challenges on care staff. These challenges often lead to prescribing of harmful medications prescribed to promote sleep.

The NightCAP study is testing a training programme for care staff to provide them with skills and strategies for improving night-time care. The study is funded through a £400,000 award from Alzheimer’s Society, and is a collaboration with King’s College London, the University of East Anglia and the Aston University.

Study lead Dr Anne Corbett, of the University of Exeter, said: “We know there’s an urgent need to support care staff and help them to use practical, effective ways of caring for their residents who are up in the night. Night shifts in care homes are often understaffed and we know that there is very little training provided for staff working these hours. There is also a need to increase awareness amongst staff and GPs about the importance of reviewing hypnotic drug prescriptions and only using them in people who really need them. We’re now looking for care homes to join us, to put our NightCAP staff training programme to the test so we can establish what really works to improve night times for staff and for residents.”

Dr Ian Maidment, Reader in Clinical Pharmacy at Aston University and a member of both study teams, said: “We need to find ways to manage sleep problems without medication, which can cause many problems including confusion, falls and broken bones, and symptoms of dementia.”

Professor Dag Aarsland, Professor of Old Age Psychiatry at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London said: "We are very pleased to be able to collaborate with the University of Exeter and to contribute to this important study. Psychological and behavioural problems are very common in people with dementia in care homes, and improving sleep has the prospect of reducing such symptoms as well as a number of other potential benefits."

Sian Gregory, Research Information Manager at Alzheimer’s Society said: “Sleep problems are common for many of the 900,000 people living with dementia. Recent studies have shown nearly one third of people living with dementia in care homes have issues with their sleep, affecting their overall quality of life during an already challenging time.

“As one of the biggest funders of dementia care research in the UK, Alzheimer’s Society is proud to be funding the NightCAP study. It’s vital we find safe and effective ways to manage sleeping difficulties which can replace existing methods such as prescribing harmful drugs associated with trips and falls. We want to empower and support dedicated care home staff to provide the very best care.

“We’re looking forward to seeing the results as NightCAP begin testing in care homes, so we can support people living with dementia to have a better night’s sleep.”

Care home staff who want to find out more about NightCAP can contact the NightCAP team at Nightcaptrial@exeter.ac.uk.

Date: 11 February 2022