Effectiveness of sleep management strategies for residents of aged care facilities: findings of a systematic review.
OBJECTIVE
The objectives of this systematic review were to determine the most effective tools for the assessment and diagnosis of sleep problems, as well as identify the most effective strategies for the promotion of sleep within this population.


BACKGROUND
Experiencing reduced sleep quality is often associated with normal ageing, however this may be exacerbated for residents of aged care facilities. External factors such as noise, light and night-time nursing may impact negatively upon sleeping patterns.


METHODS
Eleven electronic databases and the reference lists and bibliographies of included studies were searched. Papers were grouped according to type of intervention or assessment tool and presented in a narrative summary.


CONCLUSIONS
The review identified many interventions to promote sleep. Multidisciplinary strategies such as combining a reduction in environmental noise, reduction of night-time nursing care and promotion of daytime activity, are likely to be most effective for promoting sleep in the population of interest. The use of sedating medications is cautioned, as their long-term efficacy in promoting sleep is questionable. Wrist actigraphy was found to be the most accurate objective sleep assessment tool.


CONCLUSIONS
Lack of sleep, disturbed sleep and the overuse of medications especially sedations reduce the quality of life for older people. Effective, safe sleep interventions should be promoted and practised by nurses.
Koch
Susan
S
Gerontic Nursing Clinical School, La Trobe University, Bundoora, Australia. s.koch@latrobe.edu.au
Haesler
Emily
E
Tiziani
Adriana
A
Wilson
Jacinda
J
D000368:Aged; D003704:Dementia / Q000150:complications; D015444:Exercise; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration*; D006272:Health Facility Environment / Q000458:organization & administration; D006293:Health Promotion; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D008029:Lighting / Q000009:adverse effects; D009551:Night Care; D009622:Noise / Q000009:adverse effects; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009735:Nursing Homes / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D017286:Polysomnography; D011788:Quality of Life / Q000523:psychology; D012107:Research Design; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012449:Safety; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology
D006993:Hypnotics and Sedatives