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Non-pharmacological measures for sleep problems in dementia: time to forget sleeping pills?

Part of: BJPsych Advances Cochrane Corner and Round the Corner Collection

Published online by Cambridge University Press:  09 October 2025

Felicity Cornforth Open the ORCID record for Felicity Cornforth [Opens in a new window] ,
Nina Baruch  and
Tomasz Bajorek
Felicity Cornforth*
Affiliation:
A specialty doctor working in an older adult community mental health team at Warneford Hospital, Oxford, UK. She is interested in holistic and psychosocial aspects of care, with a particular interest in old age psychiatry.
Nina Baruch
Affiliation:
A consultant liaison psychiatrist working in general liaison and acute general medicine at Oxford Psychological Medicine Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. She has a degree in psychology and cognitive neuroscience and has published several academic articles, mainly on old age psychiatry.
Tomasz Bajorek
Affiliation:
A consultant liaison psychiatrist working in general liaison, palliative care and neuropsychiatry at Oxford Psychological Medicine Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. He has a degree in physiological sciences and has published several books, book chapters and academic articles covering diverse areas of psychiatric research and practice.
*
Correspondence Felicity Cornforth. Email: felicity.cornforth@psych.ox.ac.uk
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Summary

Sleep disturbances are common in dementia and are associated with numerous problems. Medication is not clearly effective and is potentially problematic, giving a clear role for non-pharmacological measures. The Cochrane Review discussed here suggested that physical and social activities and carer interventions potentially improve sleep in dementia, although the evidence was not conclusive. The review was limited by the heterogeneity present and the low quality of evidence. The authors’ choice of primary outcomes leads to a wider discussion on the clinical relevance of available outcomes in evaluating sleep in dementia and the potential role for patients and carers in informing this.

Keywords

Old age psychiatrydementias/neurodegenerative diseasesliaison psychiatrysleep problemsnon-pharmacological interventions

Information

Type
Round the corner
Information
BJPsych Advances , Volume 31 , Special Issue 6: Liaison Psychiatry (Part 1) , November 2025 , pp. 326 - 330
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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Footnotes

†

Commentary on… Non-pharmacological interventions for sleep disturbances in people with dementia (Cochrane Corner). See this issue.

References

Arumugam, A, Phillips, LR, Moore, A, et al (2023) Patient and public involvement in research: a review of practical resources for young investigators. BMC Rheumatology, 7: 2.CrossRefGoogle ScholarPubMed
Besley, S, Kourouklis D, O’Neill P, et al (2023) Dementia in the UK: Estimating the Potential Future Impact and Return on Research Investment (OHE Contract Research Report). Office of Health Economics (https://www.ohe.org/wp-content/uploads/2023/07/OHE-report_Estimating-Dementia-UK.pdf).Google Scholar
Blackman, J, Swirski, M, Clynes, J, et al (2021) Pharmacological and non-pharmacological interventions to enhance sleep in mild cognitive impairment and mild Alzheimer’s disease: a systematic review. Journal of Sleep Research, 30: e13229.CrossRefGoogle ScholarPubMed
Brewster, GS, Wang, D, McPhillips, MV, et al (2024) Correlates of sleep disturbance experienced by informal caregivers of persons living with dementia: a systematic review. Clinical Gerontologist, 47: 380–407.CrossRefGoogle ScholarPubMed
Cipriani, G, Lucetti, C, Danti, S, et al (2015) Sleep disturbances and dementia. Psychogeriatrics, 15: 65–74.CrossRefGoogle ScholarPubMed
Conn, VS, Valentine, JC, Cooper, HM, et al (2003) Grey literature in meta-analyses. Nursing Research, 52: 256–61.CrossRefGoogle ScholarPubMed
Díaz-Gutiérrez, MJ, Martínez-Cengotitabengoa, M, Sáez de Adana, E, et al (2017) Relationship between the use of benzodiazepines and falls in older adults: a systematic review. Maturitas, 101: 17–22.CrossRefGoogle ScholarPubMed
Fletcher, J (2007) What is heterogeneity and is it important? BMJ, 334: 94.CrossRefGoogle ScholarPubMed
Gagnier, JJ, Moher, D, Boon, H, et al (2012) Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature. BMC Medical Research Methodology, 30: 111.CrossRefGoogle Scholar
Health Research Authority (2025) HRA Best Practice Principles of Public Involvement. HRA (https://www.hra.nhs.uk/planning-and-improving-research/best-practice/public-involvement/principles-public-involvement/).Google Scholar
Holth, JK, Patel, TK, Holtzman, DM (2017) Sleep in Alzheimer’s disease – beyond amyloid. Neurobiology of Sleep and Circadian Rhythms, 2: 4–14.CrossRefGoogle ScholarPubMed
Hopewell, S, McDonald, S, Clarke, M, et al (2007) Grey literature in meta-analyses of randomized trials of health care interventions. Cochrane Database of Systematic Reviews, 2007: MR000010.Google ScholarPubMed
Lee, DR, Thomas, AJ (2011) Sleep in dementia and caregiving – assessment and treatment implications: a review. International Psychogeriatrics, 23: 190–201.CrossRefGoogle ScholarPubMed
Li, J, Vitiello, MV, Gooneratne, NS (2018) Sleep in normal aging. Sleep Medicine Clinics, 13: 1–11.CrossRefGoogle ScholarPubMed
McCleery, J, Sharpley, AL (2020) Pharmacotherapies for sleep disturbances in dementia. Cochrane Database of Systematic Reviews, 11: 1465–858.Google ScholarPubMed
Mitchell, AJ, Shukla, D, Ajumal, HA, et al (2014) The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis. General Hospital Psychiatry, 36: 627–33.CrossRefGoogle ScholarPubMed
Mok, PLH, Carr, MJ, Guthrie, B, et al (2024) Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study. BMJ, 385: e076268.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (2018) Dementia: Assessment, Management and Support for People Living with Dementia and Their Carers (NICE Guideline NG97). NICE.Google Scholar
National Institute for Health and Care Excellence (2024) Patient and Public Involvement Policy. NICE (https://www.nice.org.uk/about/nice-communities/nice-and-the-public/public-involvement/patient-and-public-involvement-policy).Google Scholar
Paez, A (2017) Grey literature: an important resource in systematic reviews. Journal of Evidence-Based Medicine, 10: 233–40.CrossRefGoogle ScholarPubMed
Paterniti, S, Verdier-Taillefer, M-H, Dufouil, C, et al (2002) Depressive symptoms and cognitive decline in elderly people: longitudinal study. British Journal of Psychiatry, 181: 406–10.CrossRefGoogle ScholarPubMed
Räihä, I, Isoaho, R, Ojanlatva, A, et al (2001) Poor performance in the Mini-Mental State Examination due to causes other than dementia. Scandinavian Journal of Primary Health Care, 19: 34–8.CrossRefGoogle ScholarPubMed
Rapaport, P, Amador, S, Adeleke, MO, et al (2024) Clinical effectiveness of DREAMS START (Dementia Related Manual for Sleep; Strategies for Relatives) versus usual care for people with dementia and their carers: a single-masked, phase 3, parallel-arm, superiority randomised controlled trial. Lancet: Healthy Longevity, 5: 100635.Google ScholarPubMed
Rochon, PA, Vozoris, N, Gill, SS (2017) The harms of benzodiazepines for patients with dementia. Canadian Medical Association Journal, 189: 517–8.CrossRefGoogle ScholarPubMed
Stone, KL, Blackwell, TL, Ancoli-Israel, S, et al (2014) Sleep disturbances and risk of falls in older community-dwelling men: the outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. Journal of the American Geriatrics Society, 62: 299–305.Google ScholarPubMed
Webster, L, Costafreda Gonzalez, S, Stringer, A, et al (2020) Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis. Sleep, 43: zsz251.CrossRefGoogle Scholar
Wilfling, D, Calo, S, Dichter, MN, et al (2023) Non-pharmacological interventions for sleep disturbances in people with dementia. Cochrane Database of Systematic Reviews, 1: CD011881.Google ScholarPubMed
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