Sleep Interventions for Informal Caregivers of People with Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis.

Objectives: This systematic review aims to synthesize evidence on the effectiveness of non-pharmacological interventions (e.g. behavioral interventions, psychoeducational interventions) for improving sleep among caregivers of people with mild cognitive impairment or dementia. Methods: A literature search, conducted across eleven databases identified randomized controlled trials (RCTs), was conducted. The primary outcome was sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). Twenty-one RCTs involving 1,964 caregivers (mean age 64.06 years; 74.94% female) were included. Results: Compared with control conditions (usual care, enhanced usual care, or attention control), non-pharmacological interventions significantly reduced PSQI score at end-of-intervention, based on five studies involving 334 caregivers (Mean Difference=–1.27 points, 95% confidence interval [−2.34, −0.19], p=.021). All trials had a high overall risk of bias, and the certainty of evidence was very low. Conclusions: Non-pharmacological interventions may yield modest improvements in sleep quality among informal caregivers; however, confidence in this estimate is limited by high risk of bias of included studies and very low certainty of evidence.