P1-524: development of a dyadic sleep intervention for persons with alzheimer's disease and their caregivers

Studies show the negative health impact of sleep problems in both persons with Alzheimer's disease (PAD) and their caregivers. Addressing the sleep problems of both members of the dyad concurrently shows promise, but has not been tested. A sleep intervention program targeting dyads that could be administered by a trained sleep educator has the potential for wide-spread use and benefit. This study iteratively refined a dyadic sleep intervention that was built upon previous studies of PAD and caregivers. Study participants were recruited from a local Veterans Affairs healthcare system and community. Five intervention sessions addressed sleep hygiene, stimulus control, sleep compression, daily walking/light exposure, relaxation, and strategies to help caregivers manage PAD's sleep and other behavioral challenges. The intervention structure and materials were iteratively refined based on the acceptability of the program to caregivers and the usability of the program materials to sleep educators. Intervention outcomes were measured using sleep diaries each week. A weekly “good sleep” variable was calculated based on whether an individual had ≥5 nights of <30 minutes to fall asleep and <30 minutes of total wake time at night each week. Average daily walking and light exposure durations per week were also calculated. Five out of six enrolled dyads completed the intervention administered by three sleep educators (registered nurse, nurse practitioner and social worker). All PAD had probable or possible AD plus sleep problems occurring ≥3 times/week. Caregivers’ sleep was poor with a score range of 6–17 on the Pittsburgh Sleep Quality Index. In week one, caregivers experienced an average of 1.6 nights of “good sleep” and PAD experienced an average of 2.4 nights of “good sleep”, which increased to 3.8 and 4.8 nights/week, respectively in the last week of the program. After the program, minutes of walking increased for four caregivers and three PAD. Minutes of light exposure also increased for three caregivers and four PAD. Providing a dyadic sleep intervention program with PAD and their caregivers was feasible. Findings suggest that health professionals without sleep specialty training can be trained to deliver behavioral sleep education to this vulnerable population.