Effectiveness of Information and Communication Technology (ICT) Interventions in Elderly's Sleep Disturbances: A Systematic Review and Meta-Analysis

Sleep is a crucial factor for human health and is closely related to quality of life. Sleep disturbances constitute a health problem that should be solved, especially when it affects the elderly. This study aims to examine the effectiveness of information and communication technologies (ICT) interventions in managing sleep disturbances in the elderly. The study used a systematic review of three databases: Ovid-Medline, Ovid-EMBASE, and the Cochrane library database for papers published till 15 April 2021. Two authors independently selected and screened relevant studies based on predefined inclusion criteria. The meta-analysis of randomized controlled trials (RCTs) was carried out using Review Manager 5.4. Two authors independently screened the titles and abstracts of 4297 studies considering both inclusion and exclusion criteria. The complete texts of 47 articles were then evaluated, 31 articles were excluded, and finally, 16 articles were selected. Our meta-analysis showed that the cognitive-behavioral therapy for insomnia (CBT-I) group had a significantly reduced Insomnia Severity Index (ISI) compared to the control group (-4.81 [-5.56, -4.06], p < 0.00001, I-2 = 83%) in RCTs, with a significant reduction in ISI (3.47 [1.58, 5.35], p = 0.0003) found in quasi-experimental studies. A significant improvement was found in total sleep time in the CBT-I group compared to the control group (29.24 [15.41, 43.07], p <0.0001) in RCTs, while the CBT-I group showed significantly reduced wake time after sleep onset compared to the control group (-20.50 [-26.60, -14.41], p < 0.00001). In addition, a significant reduction in depression was found in the CBT-I group compared to the control group (-2.11 [-2.85, -1.37], p < 0.00001, I-2 = 0%) in RCTs. The quality of life-mental component score (5.75 [1.64, 9.87], p = 0.006, I-2 = 0%) and the quality of life-physical component score (5.19 [0.76, 9.62], p = 0.02, I-2 = 0%) showed significant improvement in the CBT-I group compared to the control group. ICT interventions showed positive effects on sleep disturbances of the elderly, specifically confirming the positive effect on depression and quality of life as well as the indicators directly related to sleep such as ISI and quality of sleep. Thus, the application of ICT in the healthcare sector will be greater in the future, with changes in the nursing education and practice guidelines so that nurses can play a pivotal role in promoting health behaviors such as sleep-related quality of life and daily activities of the elderly.