Sleep Interventions for Informal Caregivers of Persons with Dementia: A Systematic Review.

Most included studies had fewer than 50 participants, and only Williams et al. (N = 84) and Elliott et al. (N = 495) were larger. Nine of the 14 appraisable studies were high risk of bias, mainly from randomization, sleep outcome measurement, or intervention fidelity. Study designs and interventions were heterogeneous, including randomized, quasi-experimental, pre/posttest, and repeated-measures designs, so the review cannot identify which intervention was best. The search was limited to English, peer-reviewed articles from 2009 through 2019, excluded reviews and gray literature, and the protocol was not registered, so relevant studies may have been missed. Caregiver samples were relatively homogeneous, mostly White female spouses aged about 60 to 75 years. Generalizability to more diverse caregiver groups is limited. Several studies used only subjective or only objective sleep measures, investigator-derived sleep measures, or had missing outcome data. The bias assessment tool was designed for randomized trials, so conclusions about nonrandomized studies are limited.

The authors declared no potential conflicts of interest.

Do not conclude that light therapy or exercise is proven to improve sleep for dementia caregivers. The review included mostly small studies, 9 of 14 appraisable studies were high risk of bias, and some interventions combined several components, so the effect of any single component cannot be separated.