The effects of cranial electrical stimulation on sleep disturbances, depressive symptoms, and caregiving appraisal in elderly caregivers of persons with Alzheimer's disease or related dementia

Purpose. The purpose of this double-blind, placebo-controlled, randomized, clinical trial (RCT) was to investigate the effects of short-term use of cranial electrical stimulation (CES) on sleep disturbances, depressive symptoms, and caregiving appraisal in elderly, spousal caregivers for persons with Alzheimer's disease or a related dementia.; Methods. Participants were randomly assigned to receive either active CES or sham CES intervention. Participants used the CES device one hour each day for four weeks. Study outcomes were measured at baseline and at two and four weeks.; Participants. Thirty-eight participants were recruited from support groups hosted by the Central and Western Virginia Alzheimer's Association and from the general community.; Measures. Sleep outcomes were measured using the Pittsburgh Sleep Quality Index, General Sleep Disturbances Scale, and bi-weekly diaries. Depressive symptoms were measured using the Geriatric Depression Scale. Caregiving appraisal was measured using the Philadelphia Geriatric Center Caregiving Appraisal Scales.; Results. There were no significant differences between the intervention groups over time in sleep disturbances or sleep quality. A slight trend toward statistical significance was found in nighttime awakenings over time by group (p=0.94), with a decrease of scores reported by subjects in the sham CES intervention group. Slight trends toward statistically significant differences were found in participants' reports of daytime function over time (p=.091), sleep medication use by group ( p=.051), and daily disturbances by group (p=.099). Mean differences in these analyses were not clinically important. There were no significant differences between the intervention groups over time in reports of depressive symptoms. There were no significant differences between the intervention groups over time in appraisal of caregiving situation. Statistically significant differences were found in participants' scores by group on burden (p=.032) and mastery (p=.035) with the sham CES group showing improvement in these areas.; Conclusions. These findings did not demonstrate that short-term use of active CES improved sleep disturbances, depressive symptoms, or caregiving appraisal more than sham CES in the current sample of elderly, spousal caregivers. Various study limitations may have obscured potential intervention effects. Further research is needed to support the use of CES in elderly caregivers.