BACKGROUND: Nursing home residents with dementia have characteristic sleep disturbances that correlate with behavioral symptoms, risk for falls, and increased caregiver burden. Interventions to improve sleep in this population consist primarily of pharmacologic agents, which may have negative side effects. OBJECTIVES: This study examined prescribing practices for common classes of medications affecting sleep and compared users and nonusers of these medications for daytime sleep, nighttime sleep, and the percentage of 24-hr sleep that occurred at night. STUDY DESIGN: In this secondary data analysis, actigraphy measured selected sleep variables. RESULTS: 195 nursing home residents participated in the study (mean age = 80.3 years, SD 8.12 years). Of the participants, 70.8% were prescribed two or more psychotropic medications. Novel antipsychotics were the most commonly prescribed class of medication (26%). The percentage of nighttime sleep for users of selective serotonin reuptake inhibitors was 8% lower than that of nonusers (p = .005). CONCLUSION: Medications for the management of dementia, depression, and psychosis may worsen nighttime sleep of nursing home residents with dementia.
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