Severe Sleep Disturbances in Persons With Dementia With REM Sleep Behavior Disorder and Family Caregivers: A Mixed Methods Study.
Eunae Ju, Yuqing Guo, Candace Burton and 2 others
PMID 39347756WHAT IT FOUND
Two dementia-caregiver dyads reported severe night-time RBD symptoms, bed injuries and caregiver sleep disruption.
For the patients, wearable sleep times were much shorter than diary reports. These two cases describe problems and do not show that any treatment works.
Key findings
01In dyad 1, the person with dementia had an average total sleep duration of 124 minutes and sleep efficiency of 50.9% on wearable data, and the caregiver reported he hurt his head and bled.
02In dyad 2, the person with dementia had an average total sleep duration of 296 minutes and awake duration of 406 minutes, while the caregiver reported severe burden (70/88) and both had sleep disturbance scores above 5 (10/21 and 9/21).
03Caregiver diary reports of total sleep for the two persons with dementia were 619 and 476 minutes, while wearable average total sleep was 123.6 and 295.5 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only two dyads were reported, so this describes what happened to these patients and caregivers, not how common the findings are or whether any approach works. The second patient had RBD-like behaviours reported by his caregiver, not a confirmed RBD diagnosis, and the parent study did not specifically assess RBD. Sleep diary and wearable measures disagreed for total sleep, and the authors say movement may have been scored as awake, so the wearable sleep times cannot be taken as precise sleep duration. The first patient could not be interviewed independently because of limited decision-making capacity, so his own experience was not captured. Caregiver-reported RBD episodes and diary data were voluntary and not part of a planned RBD assessment.
Declared interests
The authors declared no conflicts of interest. The supplied publication types list NIH extramural research support.
The easy way to misread this
Do not read the wearable sleep durations as proof that the patients slept only 124 or 296 minutes. The authors say movement during sleep may be scored as awake, and caregiver diaries reported much longer sleep than the wearable averages.