Non-pharmacological interventions to improve the sleep of informal caregivers of people with dementia: A systematic review and meta-analysis

BACKGROUND AND OBJECTIVES: Sleep problems are common among informal caregivers of people with dementia. Although various non-pharmacological interventions developed to improve caregivers' sleep, comprehensive syntheses of their categories and effectiveness are lacking. This study synthesizes the types of non-pharmacological interventions used for this population and systematically evaluates their effects on sleep outcomes. RESEARCH DESIGN AND METHODS: Six databases (Medline, Scopus, Web of Science, Embase, PsycINFO, and CINAHL) were systematically searched for studies evaluating non-pharmacological interventions and reporting sleep outcomes in informal dementia caregivers. Two researchers independently selected studies and assessed quality. RESULTS: Of 4,147 records identified, 30 studies were synthesized and 22 meta-analyzed. Seven intervention categories were identified: multicomponent behavioral sleep interventions, sensory-based interventions, physical exercise, institutional respite care, cranial electrical stimulation, caregiver education, and nighttime monitoring systems. Pooled analyses indicated non-pharmacological interventions significantly improved overall sleep quality (SMD = -0.60, 95% CI = -1.12 to -0.08) and insomnia (SMD=-0.43, 95% CI = -0.83 to -0.04). Multicomponent behavioral interventions specifically improved overall sleep quality (SMD = -0.36, 95% CI = -0.61 to -0.12). Research on other specific sleep parameters remains limited. DISCUSSION AND IMPLICATIONS: Non-pharmacological interventions may effectively improve overall sleep quality and insomnia among informal caregivers of people with dementia. However, significant research gaps persist regarding the effectiveness of these interventions in improving specific sleep parameters. Since heterogeneity among the included studies remains high, caution is warranted when interpreting the results in practice. Future large-scale and methodologically rigorous trials are needed.