Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review

•Twenty-eight RCTs were included to identify the effects of nonpharmacological interventions on improving sleep among nursing home residents.•Physical activity, mind-body practices, acupressure and chamomile extract yielded promising results.•Mixed effects were found for bright light exposure, massage, melatonin and multicomponent interventions.•Clinicians must be educated to recognize the importance of nonpharmacological interventions for sleep in nursing home facilities. Sleep disturbance is one of the most prevalent symptoms among elderly adults, especially those living in nursing homes. Sleep disturbance adversely affects the healthcare system as well as elderly adults’ quality of life. Nonpharmacological interventions have shown promising results regarding improvements in sleep. This systematic review intended to identify the effects of nonpharmacological interventions on sleep quality and nighttime sleep among nursing home residents. We searched both English and Chinese databases through December 2018 and found 28 eligible studies describing five types of interventions: physical activity (n = 6), light therapy (n = 5), mind-body practices (n = 2), complementary and alternative therapy (n = 8), and multicomponent interventions (n = 7). Although the wide variety of interventions in each category limited the generalizability of the results, physical activity, mind-body practices, acupressure and chamomile extract intake demonstrated positive and promising impacts on sleep quality and nighttime sleep. Due to the small number of included trials, the results should be interpreted cautiously. Further higher-quality studies concerning nonpharmacological treatments are needed.