International Journal of Molecular Medical Science, 2025, Vol.15, No.4, 155-164 http://medscipublisher.com/index.php/ijmms 155 Research Insight Open Access Effect of Nursing-Based Sleep Management on Melatonin and Cortisol Levels in Geriatric Dementia Patients MinLi The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, 310009, Zhejiang, China Corresponding email: limin@qq.com International Journal of Molecular Medical Science, 2025, Vol.15, No.4 doi: 10.5376/ijmms.2025.15.0016 Received: 10 May, 2025 Accepted: 23 Jun., 2025 Published: 10 Jul., 2025 Copyright © 2025 Li, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Li M., 2025, Effect of nursing-based sleep management on melatonin and cortisol levels in geriatric dementia patients, International Journal of Molecular Medical Science, 15(4): 155-164 (doi: 10.5376/ijmms.2025.15.0016) Abstract This study explored the impact of nurse-led sleep care on melatonin and cortisol in patients with Alzheimer's disease, including creating a quieter environment, adjusting daily routines and lifestyles, and using simple relaxation methods. Studies show that these practices can help people sleep more soundly at night, increase nighttime melatonin, lower cortisol, help adjust the biological clock, and make the hypothalamic-pituitary-adrenal (HPA) axis function more stable. However, due to the small sample size, inconsistent intervention practices, and insufficient long-term follow-up, the results of each study are not completely consistent. Future research should include a larger population, conduct randomized trials in multiple centers, evaluate the effects through various methods, and formulate standardized nursing plans. Only in this way can the conclusion be repeatedly verified and applied in clinical practice. This study aims to integrate evidence-based sleep care into the daily care of dementia patients, providing a promising drug-free approach to improve physiological regulation and patient health. Keywords Dementia; Sleep management; Melatonin; Cortisol; Nursing interventions 1 Introduction Dementia is a common brain-degenerative disease in older adults and is often linked with serious sleep problems such as insomnia, broken sleep, and changes in the normal sleep-wake cycle. These sleep issues can speed up memory loss, increase behavioral problems like agitation and sundowning, and lower the quality of life for both patients and their caregivers (Morales-Delgado et al., 2018). The high rate of sleep problems in dementia shows the importance of finding effective care methods to manage both thinking-related and other symptoms (Cohen-Mansfield et al., 2000; Xu et al., 2015). Melatonin is a hormone produced by the pineal gland in darkness and helps set the body’s daily rhythm and start sleep. Its production drops with age and is often lower in older adults, especially those with dementia (Cohen-Mansfield et al., 2000). Melatonin affects sleep quality, helps protect brain health, and may influence the development of Alzheimer’s disease. Cortisol, a glucocorticoid hormone, regulates the stress response and follows a daily cycle that aligns with sleep-wake patterns. When melatonin and cortisol become unbalanced, sleep structure is harmed and neuropsychiatric symptoms in dementia can worsen (Li et al., 2020). This study will explore how nursing-based sleep care methods-such as improving the environment, using behavioral approaches, and giving sleep-promoting drugs like melatonin-can help improve sleep quality and reduce behavior problems in people with Alzheimer’s disease. Current clinical research shows that adding melatonin can extend total sleep time, raise sleep efficiency, and lessen restlessness and sundowning, though its effect on improving cognitive function is still limited. These care measures can increase patients’ life satisfaction, ease the workload for caregivers, and help maintain a less restrictive care setting. However, more studies are needed to understand how these methods affect hormone markers like melatonin and cortisol, and clinical care plans should be improved to make the interventions more effective and practical. 2 Characteristics of Sleep Disorders in Elderly Dementia Patients 2.1 Changes in sleep architecture and circadian rhythm disturbances Sleep patterns in older adults with dementia change clearly: slow- wave and REM sleep are reduced, sleep
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