Assessment of the associations between improved pain management and sleep quality, and between improved sleep and problem behaviors in patients with dementia

• Restricted to UC San Diego use only

• 2012

• Agarwal, Rishi Raj

The purpose of this study was to analyze whether or not physical pain that is unreported, undiagnosed, or untreated is a factor that contributes to poor sleep at night with subsequent worsening of problem behaviors (i.e. delusions, depression, hallucinations, aggression, wandering) during the day. This evidence-based medicine study was a single-blind trial testing the ability of acetaminophen (975mg) versus placebo to reduce pain, improve sleep, and improve problem behaviors in these hospitalized patients when given on a scheduled basis at bedtime. Enrolled patients were to be cared for and tested over a period of 16-19 days, the average length of stay for patients admitted to the Senior Behavioral Health Unit (SBHU). Repeated assessments of function and behavior were done primarily using the Mini Mental State Exam (MMSE) (1) and nursing reports, while assessments of activity were done primarily using actigraphy monitoring (a technology that tracks patient sleep, movement, and light exposure). Due to difficulties with initially enrolling patients as well as keeping patients enrolled, this study was never taken to completion. Of 25 patients enrolled, only four patients completed the entire testing period to obtain enough individual data for analysis. It was originally projected that about 125 patients would be needed to obtain statistical significance for the study. As such, the actual sample size from which any conclusions could be drawn was unable to achieve statistical significance. From these four patients who completed the study, no trends in cognitive function and behavior nor activity could be surmised as measured by the MMSE and actigraphy monitoring, respectively. The aims of this paper are to delineate the process of data gathering and analysis employed to describe the many obstacles to completing this project that were encountered, and in so doing illustrate the uniquely difficult nature of performing clinical research on this very complex patient population

1 online resource ([6] p.)

• Academic Dissertations

• Dissertations, Academic--School of Medicine. (Discipline)--UCSD

• text

Thesis (M.D.)--University of California, San Diego, 2012

Forms part of the UCSD School of Medicine independent study projects, Class of 2012

Includes bibliographical references (p. [6])

• Rishi Raj Agarwal

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2020-10-22