Summary of findings 2. Summary of findings table ‐ Physical activities compared to usual care for sleep disturbances in people with dementia.
| Physical activities compared to usual care for sleep disturbances in people with dementia | ||||||
| Patient or population: sleep disturbances in people with dementia Setting: nursing home Intervention: physical activities Comparison: usual care | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with usual care | Risk with physical activities | |||||
| Total nocturnal sleep time (minutes) | The mean total nocturnal sleep time in the control group was 438.3 minutes (McCurry 2011) and 328.9 minutes (Richards 2011). Total nocturnal sleep time with physical activity was 11.80 minutes higher (28.63 lower to 52.23 higher) in McCurry 2011 and 11.8 minutes higher (16.14 lower to 39.74 higher) in Richards 2011. | 167 (2 RCTs) | ⊕⊕⊝⊝ Lowa,b | Both studies reported differences between groups for total nocturnal sleep time in favour of the intervention group after 7 weeks and 2 months (McCurry 2011; Richards 2011). | ||
| Consolidated sleep ‐ not measured | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ |
| Sleep efficiency | The mean sleep efficiency in the control group was 78.1% (McCurry 2011) and 68.5% (Richards 2011). Sleep efficiency for physical activity was 4.90% higher (0.43 lower to 10.23 higher) in McCurry 2011 and 2.60% higher (1.29 lower to 6.49 higher) in Richards 2011. | 167 (2 RCTs) | ⊕⊕⊝⊝ Lowa,c | Richards 2011 reported differences between groups in favour of the intervention group using actigraphy after 7 weeks and McCurry found little to no difference between groups after 6 months. | ||
| Total wake time at night (minutes) | The mean total wake time at night (minutes) was 122 minutes | 33.2 minutes lower (65.11 lower to 1.29 lower) | ‐ | 65 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | McCurry 2011 reported improvements in the intervention group using actigraphy after 2 months. |
| Number of nocturnal awakenings | The mean number of nocturnal awakenings was 18.4 | 3.3 lower (6.77 lower to 0.17 higher) | ‐ | 65 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | McCurry 2011 found differences between groups in favour of the intervention using actigraphy after 2 months. |
| Sleep onset latency | 1 study reported no changes after 6 months, but reported no data. | (1 RCT) | ⊕⊕⊕⊝ Moderated | Richards 2011 reported no differences between groups using actigraphy after 7 weeks. | ||
| Adverse events | 1 study reported unexpected and serious adverse events (Richards 2011). 1 participant had substernal chest pain 15 hours after exercising, but was negative for myocardial infarction; 1 had back, hip, and leg pain; and 1 had multifocal premature ventricular contractions or non‐specific t‐wave changes in their electrocardiogram. | 167 (2 RCTs) | ⊕⊕⊕⊝ Moderatea | ‐ | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
| See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_424365659920486101. | ||||||
a Downgraded one level for risk of bias: high risk of a performance bias in one study. b Downgraded one level for imprecision: only one study with a small number of participants. c Downgraded one level for imprecision: wide confidence intervals. d Downgraded one level for imprecision: no data reported.