Caregiver Reports of Sleep Problems in Non-Hispanic White, Hispanic, and African American Patients with Alzheimer Dementia

Department of Psychiatry and Public Health, Nova Southeastern University, Fort Lauderdale, FL, USA.
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine (Impact Factor: 3.05). 06/2010; 6(3):281-9.
Source: PubMed


Sleep problems are common in persons with dementing illnesses and among the most stressful patient behaviors for caregivers. Although studies have shown differences in sleep across ethnic groups, little information is available on ethnic differences among persons with dementia. The purpose of this study was to investigate possible ethnic differences in sleep problems among patients with Alzheimer dementia.
Caregiver reports of 5 sleep- or circadian rhythm-related behavioral problems (behavior disturbance worse in the evening, difficulties falling asleep, frequent awakenings, early awakenings, and excessive daytime sleep) were evaluated in 395 patients who had received a diagnosis of Alzheimer disease after diagnostic evaluation. The average cognitive score of the groups suggested that they could be characterized as having moderately severe impairment. The frequency of sleep problems was then evaluated across subgroups defined by self-reported ethnicity (African American, Hispanic, and non-Hispanic white). As patient and caregiver characteristics may affect caregivers' reports of patients' behaviors, mixed effects regression models were used to adjust for patient and caregiver variables that might affect caregiver reports.
Analyses revealed ethnic differences in sleep or circadian rhythm disturbances. African American and Hispanic patients were reported to have more severe sleep disturbances than non-Hispanic whites. After correction for patient and caregiver variables that might have affected caregiver reports, differences between African Americans and others remained.
Sleep problems in patients with dementing illnesses are reported by caregivers with differing frequencies across groups of African Americans, Hispanics, and non-Hispanic whites. Clinicians should be aware of these differences in assessing sleep disturbance in patients with dementia as well as the potential effects of patient and caregiver variables on reports of these problems.

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Available from: Raymond Ownby
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    • "ise , 2004 ) , are not necessarily effective for all cases . Nevertheless , clinicians are at times pressured to prescribe such medications despite lack of evidence for efficacy and increased risks , especially since insom - nia in demented patients is frequently accompanied by disruptive behaviour , rising from bed and increased risk of falling ( Ownby et al . , 2010 ; Rowe et al . , 2009 ) , which endanger the patient or are intolerable for the support system ( Gallagher - Thompson et al . , 1992 ; Pollak et al . , 1990 ) . A variety of medications are being prescribed for sleep disturbances in demented individuals , including benzodiazepines ( Rikala et al . , 2011b ; Tsunoda et al . , 2010 ) , an"
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