Behavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Res Nurs Health. 2020 Dec;43(6):557-567. doi: 10.1002/nur.22081. Epub 2020 Nov 2.
Sleep disruption in older adults living with Alzheimer's disease and related dementias (ADRD) is debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers, such as decreased quality of life and increased caregiver burden. Given the potentially harmful side effects of pharmacologic treatment, nonpharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. A growing body of literature suggests that calming tailored music may improve sleep quality in older adults with memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If shown to be feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. This protocol details a wait-list randomized controlled trial (NCT04157244), the purpose of which is to test the feasibility, acceptability, and examine the preliminary efficacy of a tailored music listening intervention in older adults with ADRD who report sleep disruption. Music selections will be tailored to the music genre preferences of older adults with ADRD and account for known sleep-inducing properties. The feasibility of processes that is key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy-reported) sleep quality measures. In addition, qualitative data will be solicited, examining the acceptability and satisfaction with the intervention by individuals with ADRD.
阿尔茨海默病和相关痴呆症(ADRD)患者的睡眠障碍会使其衰弱,并导致其更多地住院治疗、认知功能下降以及疾病加速进展。此外,睡眠障碍还与护理人员的健康结果不良有关,例如生活质量下降和护理人员负担增加。鉴于药物治疗可能产生有害的副作用,非药物治疗方法,如音乐,可能为减少这一脆弱人群的睡眠障碍提供更安全的选择。越来越多的文献表明,定制的舒缓音乐可能会改善有记忆障碍的老年人的睡眠质量,但在社区中患有 ADRD 的老年人中,其疗效尚未得到证实,而大多数患有 ADRD 的老年人都居住在社区中。如果证明可行且可接受,那么可以针对减少睡眠障碍的效果来测试定制音乐干预措施。本方案详细说明了一项等待名单随机对照试验(NCT04157244),其目的是测试针对报告有睡眠障碍的 ADRD 老年人的定制音乐聆听干预措施的可行性、可接受性和初步疗效。音乐选择将根据 ADRD 老年人的音乐类型偏好进行定制,并考虑到已知的助眠特性。将检查对后续研究成功至关重要的流程的可行性。干预措施的初步疗效将使用客观(活动记录仪)和主观(代理报告)睡眠质量测量进行评估。此外,还将征求定性数据,以了解患有 ADRD 的个体对干预措施的可接受性和满意度。