Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER).
Jennifer L Martin, Mary Cadogan, Abraham A Brody and 6 others
PMID 38493807WHAT IT FOUND
Device-measured night sleep did not improve in 72 nursing home residents, but a staff program combining webinars, workshops, and texts improved self-reported sleep quality; daytime gains were not sustained.
Key findings
01The staff program combined webinars, workshops, and text messages, and residents' self-reported sleep quality improved at both follow-up visits.
02Device-measured night sleep did not improve, although daytime sleep increased at the post-intervention visit.
03Depression scores and observed daytime activity improved at the post-intervention visit but were not consistently sustained at the later follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study stopped early because of COVID-19, so only 72 residents from two facilities were analysed and subgroup analyses were not possible. All units received the program at different times, and there was no concurrent control group, so natural change over time cannot be separated from the intervention. The paper does not report how often staff used sleep-promoting strategies, which strategies they used, or whether agency and non-engaged staff diluted the intervention. Average staff attendance was 5.4 staff per live webinar shift and 4.8 staff per workshop shift, so the dose reaching residents is unclear. Some improvements appeared only after the intervention quarter, and observed daytime gains were not sustained at 3 months, so persistence and timing are uncertain. Webinars, workshops, and text messages were delivered together, so the effect of any single component cannot be separated.
Declared interests
The article is labelled as NIH extramural research support, and the authors report no conflicts with any product mentioned or concept discussed.
The easy way to misread this
Do not conclude that this staff program reliably improves resident night sleep; device-measured night sleep did not change, and without a concurrent control group natural time trends cannot be ruled out.