Prevalence of sleep disturbances in German nursing home residents with dementia: A multicenter cross-sectional study

Abstract

Background: Sleep disturbances and insomnia occur frequently in people with dementia and are associated with a number of problems for affected persons, relatives, and carers. Objective: Considering the lack of high-quality data especially from Germany, this study aimed to determine the prevalence of sleep disturbances and possible associated factors with in German nursing home residents. Methods: Multicenter cross-sectional study. Nursing homes in Northern Germany were randomly selected from nursing home registers and contacted consecutively. All residents with cognitive impairment living in the nursing homes were included. Data collection took place between June and December 2017. In addition to the characteristics of nursing homes, nurses, and residents, sleep disturbances of residents with dementia were assessed using the Sleep Disorder Inventory (SDI). Descriptive statistics were applied for prevalence assessment. A generalized linear mixed model was used to investigate associated factors. Results: 38 nursing homes and 1,187 residents with cognitive impairment were included in the study. Sleep disturbances were reported for 23% of residents with pronounced differences between centers, ranging from 0-85%. The prescription of psychotropic drugs (OR 4.47; 95% CI 3.06-6.43; p<0.01), residence at a specialized dementia care unit (OR 2.43; 95% CI 1.30-4.53; p<0.01), and male sex (OR 1.56, 95% CI 1.08-2.25, p<0.02) were significantly associated with sleep problems. Conclusions: In Germany, prevalence of sleep disturbances in people with dementia is comparable to reports from other countries. Therefore, the development and rigorous evaluation of preferably non-pharmacological interventions is strongly warranted.