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

Richards KC, Beck C, O'Sullivan PS, Shue VM. Effect of individualized social activity on sleep in nursing home residents with dementia. Journal of the American Geriatrics Society. 2005 Sep 1; 53(9):1510-7.

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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.

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