Non-Pharmacological Sleep Interventions for Dementia Caregivers; A Systematic Review of Randomized Controlled Trials

Background: Caregivers of people living with dementia frequently report poor sleep. This systematic review describes evidence from randomised controlled trials of non-pharmacological sleep interventions for dementia carers. Methods: A systematic search of major databases was undertaken. Risk of bias was assessed using the Cochrane ROB 2.0 tool. Narrative synthesis followed Synthesis Without Meta-analysis (SWiM) guidelines due to substantial heterogeneity. Findings: Eighteen articles were included. Risk of Bias analyses revealed most studies had high overall risk of bias, primarily from selection of reported result bias. Interventions comprised of five categories: sleep-promoting, carer well-being, exercise, technology-based and complementary therapy. High variability between intervention type, duration, sample size and sleep measures impeding direct comparisons. Seven studies (39%) identified statistically significant improvements in caregivers sleep from exercise interventions, multi-component interventions and psychological support interventions. Conclusions: Exercise and psychological support interventions demonstrated the most promising effects, though larger, high-quality trials are needed for definitive evidence.