Evidence map›Paper›PMID 40116618›Full record

Trial reportAge and ageing2025

Process evaluation in a randomised controlled trial of DREAMS-START (dementia related manual for sleep; strategies for relatives) for sleep disturbance in people with dementia and their carers.

Sarah Amador, Gill Livingston, Mariam Adeleke, Julie Barber, Lucy Webster, Hang Yuan, Sube Banerjee, Ankita Bhojwani, Georgina Charlesworth, Christopher Clarke and 14 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The DREAMS START intervention for sleep in dementia: Long-term follow-up of a randomized controlled trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Sarah AmadorUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.ORCID 0000-0003-4196-6410
Gill LivingstonUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.ORCID 0000-0001-6741-5516
Mariam AdelekeUniversity College London, Department of Statistical Science, London, WC1E 6BT, England, UK.
Julie BarberUniversity College London, Department of Statistical Science, London, WC1E 6BT, England, UK.
Lucy WebsterUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.ORCID 0000-0001-9152-4990
Hang YuanUniversity of Oxford, Nuffield Department of Population Health, Oxford, OX3 7LF, England, UK.
Sube BanerjeeUniversity of Nottingham, Faculty of Medicine and Health Sciences, Nottingham, NG7 2UH, England, UK.
Ankita BhojwaniUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Georgina CharlesworthUniversity College London, Division of Psychology and Language Sciences, London, WC1N 1PF, England, UK.
Christopher ClarkeTees Esk and Wear Valleys NHS Foundation Trust, Darlington, DL2 2TS, England, UK.
Caroline ConnellTees Esk and Wear Valleys NHS Foundation Trust, Darlington, DL2 2TS, England, UK.
Colin A EspieNuffield Department of Clinical Neurosciences University of Oxford - Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Oxford, OX1 3QU, England, UK.
Ruochen GanUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Lina GonzalezUniversity College London, Research Department of Primary Care and Population Health, London, NW3 2PF, England, UK.
Rossana HorsleyAlzheimer's Society, London, EC3N 2AE, England, UK.
Rachael M HunterUniversity College London, Research Department of Primary Care and Population Health, London, NW3 2PF, England, UK.
Simon D KyleNuffield Department of Clinical Neurosciences University of Oxford - Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Oxford, OX1 3QU, England, UK.
Malvika MuralidharUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Liam PikettUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Malgorzata RaczekBrighton and Sussex Medical School, Centre for Dementia Studies, Brighton, BN1 9PX, England, UK.
Marija TaneskaUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Zuzana WalkerUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.
Zuyu WangUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.ORCID 0000-0002-8775-4280
Penny RapaportUniversity College London, Mental Health of Older People Department, Division of Psychiatry, London W1T 7NF, England, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDREAMS-START is a multicomponent intervention targeting sleep disturbance in people with dementia. To enhance understanding of the DREAMS-START randomised controlled trial, which showed improved sleep in the intervention compared to the control arm, we conducted a process evaluation exploring (i) DREAMS-START delivery, (ii) behaviour change mechanisms and (iii) contextual factors impacting outcomes.

methodsMixed-methods design. We measured intervention adherence, fidelity and additional therapeutic process measures. We interviewed a sub-sample of intervention arm family carers and facilitators delivering DREAMS-START. We analysed data thematically guided by a prespecified theory of change logic model informed by the Theoretical Domains Framework. We measured movement using an actigraph worn by the person with dementia at baseline and at four- and eight-month follow-ups to explore potential mechanisms of action.

resultsAttendance was good (82.8% attended ≥4/6 sessions). Mean fidelity score (95.4%; SD 0.08) and median score for all four process measures assessed (5/5; IQR 5-5) were high. We interviewed 43/188 family carers and 9/49 DREAMS-START facilitators. We identified three overarching themes aligned with our model: (i) knowledge and facilitation enable behaviour change, (ii) increasing sleep pressure and developing skills to manage sleep disturbances and (iii) Establishing a routine and sense of control. We were unable to collect sufficient data for pre-specified actigraphy analyses.

conclusionDespite competing demands, carers attended DREAMS-START. It promoted behaviour change through supportive in-session reflection, increasing carer knowledge and skills. This was embedded between sessions and actions were positively reinforced as carers experienced changes. Results will inform future implementation in clinical services.

Indexed as

CaregiversDementiaSleepSleep QualitySleep Wake DisordersActigraphyAgedAged, 80 and overFemaleHumansMaleMiddle AgedTime FactorsTreatment Outcomedementiainterventionmulticomponentolder peopleprocess evaluationsleep disturbance

Identifiers

PMID40116618
PMCPMC11926977

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.