spring 2013

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Sleep and dementia survey results help reduce evidence-to-practice gap

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Results of a 2012 survey conducted to determine what health care providers know about sleep problems in older adults living with dementia, as well as what types of assessments and interventions are commonly used to address sleep problems.

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In 2012, NLMA members were invited to participate in a cross-Canada survey on the use of non-pharmacological sleep interventions for persons with dementia. The survey was conducted by the Sleep and Function Interdisciplinary Group (SAFIG) at the University of Alberta. It aimed to determine what health care providers know about sleep problems in older adults living with dementia, as well as what types of assessments and interventions are commonly used to address sleep problems.

The survey also asked health care providers about what prevents or helps them to recommend non-drug sleep interventions such as massage, bright light therapy, temperature control and other types of environmental modification to promote better sleep.

“Over 2000 people participated in the survey, so although it took a long time to analyze such extensive data, we learned a great deal from the findings and are very pleased to be able to now share the report,” said research lead Dr. Brown, Associate Professor, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta.

“We are now in the planning stages for an intervention study and thanks to (the survey participants) we are better informed about the priority knowledge needs in the health care community.”

Between 50-70% of older adults with Alzheimer’s and other dementias (AOD), have sleep problems. These sleep problems result from, and contribute to, the development of dementia and can lead to accelerated cognitive and functional decline. Sleep disturbances in people with AOD are also one of the most common causes of anxiety and sleeplessness for family caregivers, which increases the probability of institutionalization.

The survey revealed that, like similar studies in other countries, many health care providers had little knowledge about what the risk factors for poor sleep were, what types of health conditions insomnia could make worse, and what types of assessments and non-drug interventions were research tested and available. It also found that health care providers were concerned about sleep problems and were very eager for more information about assessments and non-drug sleep interventions for older adults with Alzheimer’s and other dementias.

People in each health care provider category also identified the best ways to get information from research studies to their group so that they could begin to apply it in their daily work.

Based on the survey findings, researchers developed specific recommendations about how best to reduce the sleep and dementia evidence-to-practice gap. They can be applied by policy makers and health educators to develop specific educational strategies and care guidelines to improve health care providers’ ability to provide the best, research-informed, care for older adults living with sleep problems and dementia.

The recommendations include building sleep problem screening and advocacy capacity in the health care providers who spend the most time with persons with dementia (PWD); making sleep a higher priority topic for education of health care providers; educating providers about the effect of caregiver beliefs and co-morbid conditions on disordered sleep for PWD; educating providers about effective non-drug sleep interventions; tailoring providers’ education to fill the specific knowledge gaps of each discipline; and, educating caregivers to facilitate a change in their beliefs and awareness of effective non-drug interventions for disordered sleep.

They also call for improved sleep screening and assessment by embedding sleep-related questions in generic elder-care screening tools, and improving access to appropriate sleep assessment tools.

The priority requirements for delivering effective knowledge translation strategies to reduce the research-to-practice gap include customizing local context; incorporating a range of formats for learners’ preferences; developing strategies based on an awareness of organizational culture; respecting and building on prior knowledge; avoiding ageist assumptions of communication methods, focusing on evidence-based principles for increased health literacy; and, focusing on practicality of the information.

The full report is available online at the University of Calgary website.



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Sleep and Dementia survey results help reduce evidence-to-practice gap

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