Improving night-time care and reducing hypnotic drug use in care homes

Research project: Improving night-time care and reducing hypnotic drug use in people with dementia living in care homes (NightCAP): A randomised factorial trial

Lead Investigator: Dr Anne Corbett

  • Institution: University of Exeter 
  • Grant type: Project grant
  • Duration: 36 months
  • Amount: £399,999.42

Why did we fund this research?

Comments from our Research Network volunteers:

Speaking as a former family carer for my mum who had dementia, I cannot stress strongly enough what a huge impact the issue of sleep disturbance has on the health and wellbeing of people living with dementia and their carers. This sounds like an excellent project and I give my support.

Project summary

During this project, the research team will aim to improve the care given to people with dementia during the night in care homes. They will be focusing particularly on reducing the use of hypnotic drugs through the NightCAP programme. 

The background 

Sleep problems in people with dementia in care homes are extremely common. Disturbances can lead to poorer quality of life, worsening dementia and loss of opportunities for eating and socialising during the day. They can also cause distress to other residents and place considerable burden on care staff. These challenges often lead to prescribing of harmful medications prescribed to promote sleep.

This includes sedative antidepressants, low dose antipsychotics, antihistamines and melatonin as well as benzodiazepines and Z-drugs.

There is an urgent need to identify alternative ways of managing sleep disturbance. Research also suggests we need to improve the skills and knowledge of night-time care staff and encourage GPs to review and withdraw the use of hypnotic drugs. Surprisingly, there is currently no evidence-based guidance or training for staff in providing night-time care.

What does this project involve?

This project will build on recent previous work by this team which developed:

  •  a staff training programme for night-time care called NightCAP 
  • WHELD, a care home programme that has already been shown to improve quality of life, reduce antipsychotic drug prescribing and behavioural symptoms by training staff in person-centred care, improving social interaction and reviewing antipsychotic use of residents. 

The next steps of this project will be to deliver a clinical trial of the NightCAP programme. The research team want to find out which elements of the programme are most likely to benefit people with dementia and should be included in best practice for night-time care in the future. 

The first stage of the project will develop a protocol to review the use of hypnotic drug by GPs and adapt the existing NightCAP programme for the trial. This will involve creating materials to deliver the programme for care staff and GPs.

The second stage will be a  clinical trial to evaluate the impact of NightCAP on the use of hypnotic drug and sleep disturbances. 

How will this project help people with dementia?

The project will deliver the first ever evidence-based programme for improving night-time care in care homes. 

If successful, it will reduce the use of harmful medications in people with dementia. This could lead to improved symptoms and wellbeing and introduce a more positive approach to night-time care. 

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