ENVIRONMENTAL INTERVENTIONS ON SLEEP IN THE NURSING HOME

说明(改编自调查员摘要)：的主要目的 该项目旨在测试旨在改善环境的干预措施 养老院夜间睡眠与日间嗜睡的减少 居民。干预的目标将是改善破坏性 导致睡眠障碍的环境条件。本5年期 该项目将在4个社区进行随机对照试验 养老院，预计招收120名学科。居民有以下问题 白天嗜睡和夜间睡眠障碍都将成为目标 这项研究。被随机分配到治疗组的受试者将得到 白天/夜间(即24小时)的干预 以前测试过的夜间干预措施(涉及减少 噪音、光线和干扰睡眠的护理做法) 干预(包括有组织的睡眠和觉醒时间，自然明亮 光照，增加体力活动，限制花在 床)。对照受试者将接受常规护理。结果衡量标准将 包括睡眠与清醒(按24小时手腕估算 动作)和行为(通过24小时的行为观察来衡量)。在……里面 此外，干预过程的某些措施将是 收集的数据(即噪音水平、光照、卧床时间和活动 水平)来检验干预的理论框架。少校 假说是干预将与改善 夜间睡眠减少，白天嗜睡和烦躁不安减少。结果： 这一应用可能会给疗养院带来巨大的变化 环境，具有显著改善质量的潜力 这一弱势群体的生活和福祉。

DESCRIPTION (adapted from investigator's abstract): The primary purpose of this project is to test an environmental intervention aimed at improving nighttime sleep and decreasing daytime sleepiness among nursing home residents. The intervention will be targeted at improving disruptive environmental conditions that contribute to sleep disturbance. This 5-year project will be a randomized, controlled trial performed in 4 community nursing homes, with an expected enrollment of 120 subjects. Residents with both daytime sleepiness and nighttime sleep impairment will be targeted for the study. Subjects randomized to the treatment group will receive a daytime/nighttime (i.e., 24-hour) intervention that combines a previously-tested nighttime intervention (involving measures to decrease noise, light and sleep-disruptive nursing care practices) with a daytime intervention (involving structured sleep and awakening times, natural bright light exposure, increased physical activity, and limitation of time spent in bed). Control subjects will receive usual care. Outcome measures will include measures of sleep versus wakefulness (estimated by 24 hour wrist actigraphy) and behavior (measured by 24 hour behavioral observations). In addition, certain measures of the process of the intervention will be collected (i.e., noise levels, light exposure, in-bed time, and activity levels) to test the theoretical framework of the intervention. The major hypotheses are that the intervention will be associated with improvement in nighttime sleep and decreased daytime sleepiness and agitation. Results of this application may lead to dramatic changes in the nursing home environment, with the potential for significant improvement in the quality of life and well-being of this vulnerable population.