Abstract

Abstract: Background: In the UK, there are 850,000 People Living With Dementia and 2.4 million people with Minor Cognitive impairment. Sleep problems are common in Dementia of all types (20-90%) and Minor Cognitive Impairment (18.3–45.5%). There are no licensed medications for this and medicines used have harms. Sleep management in people with cognitive impairment is an example of a ‘wicked design problem’ because the problem is complex, the knowledge required to understand and address it includes multiple disciplines and subject expertise, and because interventions do not ‘fix’ but support best management in context.

• Age-related changes e.g. lower sleep efficiency, weakening of circadian entrainment, visual impairment, contributing to sleep-wake rhythm abnormalities.
• Psychological disorders e.g. stress, anxiety or depression.
• Medicine side effects e.g. Donepezil (medicine licensed for dementia) and nightmares.
• Co-morbidities e.g. arthritis, heart failure, reflux and obstructive sleep apnoea. *Environmental factors e.g. excessive nocturnal noise or light, low daytime light exposure, uncomfortable room temperature, polution and nocturnal care practices.
• Activity levels e.g. reduced physical activities, social disengagement and daytime napping.

In this presentation we will consider the following key issues:

1. Sleep
2. Sleep in dementia/MCI
3. Prevention of dementia and sleep
4. Harms of medication in dementia/mci
5. Suggested solution in dementia/mci
6. TIMES prototype