Alessi 1999.

Study characteristics
Methods	Study design: RCT Follow‐up: week 14
Participants	Country: USA, Los Angeles Setting: 1 long‐term care facility Inclusion criteria: urinary incontinence sleep problems dementia Exclusion criteria: coma expected length of stay or life expectancy < 3 months severe physical aggression Number of participants completing the study: 29 (IG 15, CG 14) Baseline characteristics: age (years, mean): IG 88.6 (SD 10.4); CG 88.3 (SD 5.7) gender (female): IG 87%, CG 93% MMSE score (mean): IG 13.6 (SD 8.5); CG 13.1 (SD 8.1) CIRS‐G Score (mean): IG 13.1 (SD 5.2); CG 14.3 (SD 4.6) Group differences: no differences between groups for demographic data differences for sleep parameters
Interventions	Intervention: daily physical activity for 14 weeks, noise reduction night‐time programme for the last 5 days the of intervention, education for staff, reminding signs. Intervention consisted of functional incidental training, performed during daily nursing care routines (e.g. toileting). Training included arm and leg exercises, sit‐to‐stands, and walking or wheelchair propulsion, depending on participants' abilities. Trained research staff conducted the training sessions every 2 hours between 8.00 a.m. and 16.00 p.m. (maximum 5 sessions a day). Intervention performed 5 days a week, for 14 weeks in total. After the 14 weeks, the additional night‐time programme was introduced for 5 nights. This aimed to minimise light, noise, and sleep‐disruptive nursing care interventions at night. Control: noise reduction night‐time programme
Outcomes	Percentage of night‐time sleep (actigraphy) Maximum duration of sleep episodes, minutes (actigraphy) Mean duration of sleep episodes, minutes (actigraphy) Daytime sleep, percentage (observation)
Funding	Sponsorship source: UCLA Claude Pepper Older Americans Independence Center Scpulveda VA Geriatric Research, Education and Clinical Center
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Sequence generation	Unclear risk	Of the remaining 29 participants, 15 were randomised to receive the combined daytime physical activity plus night‐time environmental programme (IG), and 14 were randomised to receive the night‐time programme alone (CG).
Allocation concealment	Unclear risk	Unknown.
Blinding of participants and personnel All outcomes	Unclear risk	Probably not blinded, but risk of bias unclear.
Blinding of participants and personnel Subjective sleep quality (carer ratings)	Unclear risk	Unknown.
Blinding of participants and personnel Objective sleep measures	Unclear risk	Unknown.
Blinding of outcome assessors Objective outcome measures	Low risk	Blinded assessment of actigraphy results (night‐time), observers blinded.
Blinding of outcome assessors Subjective sleep quality (carer ratings)	Unclear risk	No information available.
Incomplete outcome data All outcomes	Low risk	No information about 4 dropouts.
Selective outcome reporting	Unclear risk	No protocol identified.
Other sources of bias	Low risk	None.