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

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.