Timed Activity to Minimize Sleep Disturbance in People With Cognitive Impairment

Nancy A. Hodgson, Miranda V. McPhillips, Darina V. Petrovsky, Adriana Perez, Sonia Talwar, Nalaka Gooneratne, Barbara Riegel, Subhash Aryal, Laura N. Gitlin

Research output: Contribution to journalArticlepeer-review


Background and Objectives: Sleep disturbances occur in >60% of persons living with cognitive impairment, affecting their quality of life (QOL). Regulating the sleep-wake cycle through engaging cognitive, physical, and sensory-based activities delivered at strategic times may reduce sleep disturbances and be a feasible nonpharmacological treatment for sleep problems. The objective of this trial was to test the efficacy of a timed-activity intervention in improving QOL and sleep disturbances in persons living with cognitive impairment. Research Design and Method: Randomized 2-group parallel design involving 209 dyads of community-residing persons living with cognitive impairment and care partners. Dyads were randomly assigned (1:1) to 1-hr home activity sessions administered weekly in the morning, afternoon, or evening over 4 weeks (the Healthy Patterns Sleep Program), or to an attention-control condition consisting of sleep hygiene training plus education on home safety and health promotion. QOL, objective and subjective sleep quality, and neuropsychiatric symptoms were assessed at baseline and 4 weeks later. Results: QOL was significantly improved in the intervention group compared to control (p = .0491). There were no significant effects on objective or subjective sleep or neuropsychiatric symptoms. In a subgroup analysis, subjective sleep as measured by the PROMIS (Patient Reported Outcomes Measurement Information System) Sleep-Related Impairment survey was significantly improved in the intervention group compared to the control group for individuals with symptoms of depression (p = .015) or poor observed sleep at baseline (p = .005). Discussion and Implications: The Healthy Patterns Intervention may benefit QOL for persons living with cognitive impairment and those with poor subjective sleep. A longer dose may be necessary to elicit improvement in actigraphically measured sleep-wake activity.

Original languageEnglish (US)
Article numberigad132
JournalInnovation in Aging
Issue number1
StatePublished - 2024
Externally publishedYes


  • Cognitive impairment
  • Dementia family caregiving
  • Nonpharmacological strategies
  • Quality of life
  • Sleep disturbances

ASJC Scopus subject areas

  • Health(social science)
  • Life-span and Life-course Studies
  • Health Professions (miscellaneous)


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