The DREAMS START intervention for sleep in dementia: Long-term follow-up of a randomized controlled trial.
Rapaport P., Adeleke MO., Barber JA., Gonzalez L., Hunter R., Manela M., Amador S., Banerjee S., Charlesworth G., Clarke C., Espie CA., Kyle SD., Raczek M., Walker Z., Livingston G.
INTRODUCTION: Sleep disturbances are common and distressing for people with dementia and their family caregivers, with limited treatment options. The DREAMS START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) multi-component intervention for sleep disturbance in people at home with dementia is clinically and cost-effective at 8 months. In this long-term follow-on study, we assessed 2-year clinical effectiveness. METHODS: We recruited dyads of people with dementia and their family caregivers from community settings, for a two-arm, multi-center, single-blind, parallel-arm, superiority trial with the primary outcome Sleep Disorders Inventory (SDI). Analyses were intention to treat. RESULTS: We randomized 377 dyads, 189 to treatment-as-usual (TAU) and 188 to intervention; 177 dyads (46.9%) were followed up at 24 months. Two-year adjusted mean SDI score was lower in the intervention arm than TAU (-5.40; 95% CI -9.14 to -1·67; p = 0·005). DISCUSSION: In this follow-on study we demonstrate 2-year improvement in sleep disruption for people with dementia. DREAMS START has potential for delivery at scale.