Background: Advancing age is associated with high prevalence of pain, sleep problems
and dementia. Dementia is frequently accompanied by distressing behavioral and psychological
symptoms, including sleep problems. The etiology of sleep problems in dementia is multifactorial. It
has been suggested that untreated pain may contribute to sleep problems, and pain treatment has been
shown to reduce sleep problems in people with dementia.
Objective: This systematic review aims to provide an overview of the studies that have investigated
the association and/or possible interaction between pain and sleep in dementia.
Methods: A systematic search was performed in MEDLINE, EMBASE, Cochrane and PsychINFO,
including text words and MESH terms covering dementia, pain and sleep. Also, reference lists in the
included publications were examined to retrieve publications. Publications had to investigate sleep
and pain in relation to dementia to be included in this review.
Results: The search produced 1750 independent hits. Out of the 49 publications studied in full text,
11 publications were included. Only one controlled trial was identified and represented the only insights
to the possible interactional relationship between pain, sleep and dementia. Pain or pain intensity
were related to sleep in 6 of the included studies, while the remaining studies could neither support
nor contradict a relationship between sleep and pain in people with dementia. None of the studies
employed objective sleep assessment.
Conclusion: There is a need for high quality studies investigating the interaction between sleep and
pain in people with dementia, using objective sleep measurements and pain assessment suitable for
people with dementia.