The DREAMS START multi-component intervention for sleep disturbance in people with dementia demonstrated sustained 2-year improvement in sleep disruption, with adjusted mean Sleep Disorders Inventory score significantly lower in the intervention arm than treatment-as-usual.
The DREAMS START intervention produced a statistically significant reduction in Sleep Disorders Inventory scores at 2-year follow-up compared to treatment-as-usual.
377 dyads of people with dementia and their family caregivers were randomized, with 177 dyads (46.9%) followed up at 24 months.
The DREAMS START intervention had previously been shown to be clinically and cost-effective at 8 months, and this follow-on study extends the evidence of effectiveness to 2 years.
Sleep disturbances in people with dementia are described as common and distressing for both people with dementia and their family caregivers, with limited treatment options available.
This research examined whether a behavioral program called DREAMS START, designed to help people with dementia sleep better, continued to work two years after the study began. The program involves both the person with dementia and their family caregiver, and uses multiple strategies to address sleep problems at home. Researchers randomly assigned 377 pairs (dyads) of people with dementia and their caregivers to either receive the DREAMS START program or continue with their usual care, then measured sleep disturbance using a standardized scale called the Sleep Disorders Inventory. The results showed that people with dementia who received the DREAMS START intervention had meaningfully better sleep scores at the two-year mark compared to those who received usual care, with the difference being statistically significant (a reduction of about 5.4 points on the sleep scale). This builds on earlier findings showing the program was effective and cost-effective at 8 months, and now demonstrates that benefits can persist over a much longer period. This research suggests that a structured, non-drug approach to sleep problems in dementia can have lasting benefits beyond the initial treatment period. Sleep disturbances are very common in people with dementia and can be exhausting for family caregivers, yet there are few effective treatments available. The authors note that DREAMS START has potential to be delivered widely, which could make this approach accessible to many families caring for loved ones with dementia at home.
Rapaport P, Adeleke M, Barber J, Gonzalez L, Hunter R, Manela M, et al.. (2026). The DREAMS START intervention for sleep in dementia: Long-term follow-up of a randomized controlled trial.. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.71274