Developing a structured framework to explore the experiences of people with dementia and their caregivers regarding non-pharmacological sleep interventions.
Huisman C, Loomans M, Kort H • Alzheimer's & dementia : the journal of the Alzheimer's Association • 2026
A structured framework called DESMEE-CAP was developed through literature review, expert consensus, and co-creation to assess user experiences and monitor sleep and indoor environmental quality parameters for non-pharmacological sleep interventions in community-dwelling people with dementia and their caregivers.
Key Findings
Background
Sleep disturbances are common in people with dementia and contribute to increased caregiver burden, highlighting the need for effective non-pharmacological interventions.
Pharmacological treatments for sleep disturbances in people with dementia pose risks, motivating the search for non-pharmacological alternatives.
The paper identifies both technological and indoor environmental quality (IEQ) measures as categories of non-pharmacological interventions (NPIs) for sleep support.
The framework was designed specifically for community-dwelling people with dementia and their caregivers.
Methods
The DESMEE-CAP framework was developed through a combination of literature review, expert consensus, and co-creation processes.
The development methodology included literature review and expert consensus prior to piloting.
The framework was developed 'in co-creation' as described by the authors.
The framework integrates methods to assess user experiences and to monitor both sleep parameters and indoor environmental quality (IEQ) parameters.
Methods
The DESMEE-CAP framework was piloted over three weeks with a small sample of community-dwelling people with dementia and their caregivers.
The pilot involved two community-dwelling people with dementia and one caregiver.
The pilot duration was three weeks.
Findings from the pilot were analyzed to improve the framework specifically regarding explanation of NPIs, questionnaires, and sleep monitoring.
Results
The final DESMEE-CAP framework demonstrated validity and utility in capturing experiences of non-pharmacological sleep interventions without disrupting participants' routines.
The framework was described as having 'demonstrated validity and utility in capturing experiences without disrupting routines.'
The framework integrates assessment of user experiences with monitoring of sleep and IEQ parameters.
The authors note the small sample size limits generalizability of findings from the pilot.
Results
Indoor environmental quality (IEQ) parameters were identified as having an impact on sleep and were incorporated into the monitoring components of the framework.
IEQ measures are categorized alongside technological measures as types of non-pharmacological interventions addressed by the framework.
The framework specifically integrates methods to monitor IEQ parameters 'due to their impact on sleep.'
This integration distinguishes DESMEE-CAP from frameworks that focus solely on behavioral or psychological interventions.
What This Means
This research describes the creation of a structured tool called DESMEE-CAP, designed to help researchers study how people with dementia and their family caregivers experience non-drug approaches to improving sleep. Sleep problems are very common in people with dementia and place significant strain on caregivers, but medication-based treatments carry risks for this population. The researchers developed the framework by reviewing existing scientific literature, gathering input from experts, and working collaboratively with the intended users — a process called co-creation. The tool covers a range of non-drug sleep supports including technology-based approaches and changes to the indoor environment (such as lighting or temperature), and it includes questionnaires alongside methods for monitoring sleep and environmental conditions.
The framework was tested in a small pilot study involving two people with dementia living in the community and one caregiver over a three-week period. Based on what was learned from this pilot, the researchers refined the framework's instructions, questionnaires, and sleep monitoring components. The final version was found to be valid and practical — it captured participants' experiences without interfering with their daily routines.
This research suggests that DESMEE-CAP could serve as a useful research tool for systematically studying which non-pharmacological sleep interventions work best for people with dementia at home. However, because the pilot involved only three participants, the findings cannot yet be broadly generalized. Further testing with larger groups will be needed to confirm its usefulness and to generate insights that could inform better, non-drug sleep support for people with dementia and those who care for them.
Huisman C, Loomans M, Kort H. (2026). Developing a structured framework to explore the experiences of people with dementia and their caregivers regarding non-pharmacological sleep interventions.. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.71081