Implementing Sleep Interventions for Older Veterans
| Status: | Archived |
|---|---|
| Conditions: | Insomnia Sleep Studies |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
| Start Date: | May 2010 |
| End Date: | May 2013 |
Sleep problems are common among older people, and research suggests that insomnia has
negative effects on health and quality of life in older adults. Prior research suggests
that insomnia symptoms are even more common among veterans compared to the general
population. In addition, people with sleep problems also often have depression and other
problems that seem to decrease their quality of life. In this study, we will test two
methods of providing behavioral sleep interventions for treating insomnia in older veterans.
The long-term objective of this work is to identify ways to improve access to these types
of behavioral sleep interventions for older veterans, in order to improve their well-being
and quality of life. This project will be conducted in outpatient clinics of the VA Greater
Los Angeles Healthcare System. Community-dwelling older veterans (aged 65 years and older)
with insomnia will be identified by a postal survey. Enrolled veterans with insomnia (N=150
total, 50 per group) will be randomized to one of three groups: 1) Individual-Behavioral
Sleep Intervention (Individual-BSI), 2) Group-based Cognitive Behavioral Therapy for
Insomnia (Group CBT-I), or 3) an active control condition (social attention/stress
management and wellness education program). Both active treatment conditions will be given
using a written manual based on CBT for insomnia, and will be provided by allied health
personnel. Data collected will include several measures of sleep, depression and quality of
life. These measures will be performed at baseline (enrollment in the study), after the
treatment is completed, and during assessments at 6-months and 12-months follow-up. Main
outcome measures will include sleep/wake patterns (sleep questionnaires and wrist
actigraphy, which is an objective estimate of sleep and wakefulness), depression and
self-reported quality of life. We hypothesize that compared to control participants,
intervention participants will have improvements in sleep and will report less depressive
symptoms and better quality of life at six months follow-up. We also expect that these
improvements will be maintained at 12-months follow-up.
Sleep disturbance is common among older people due to age-related changes in sleep, in
addition to health conditions, psychosocial issues, medication effects and a variety of
other factors that impact sleep. The evidence that insomnia has negative effects on health
and quality of life in older adults is convincing. Prior research has demonstrated that
insomnia symptoms are even more common among veterans compared to the general population.
Our own work has demonstrated that sleep problems are associated with depressive symptoms
and other impairments in quality of life in older people, and that nonpharmacological and
behavioral interventions can improve sleep in a variety of settings.
Objectives: We propose to test two methods of providing behavioral sleep interventions for
treating insomnia in older veterans. The long-term objective of this work is to identify
ways to improve access to behavioral sleep interventions for older veterans, in order to
improve their well-being and quality of life.
Methods: This project will be conducted in outpatient clinics of the VA Greater Los Angeles
Healthcare System. Community-dwelling older veterans (aged 65 years and older) with
insomnia will be identified by a postal survey. Enrolled veterans with insomnia (N=150, 50
per group) will be randomized to one of three groups: 1) Individual-Behavioral Sleep
Intervention (Individual-BSI), 2) Group-based Cognitive Behavioral Therapy for Insomnia
(Group CBT-I), or 3) an active control condition (social attention/stress management and
wellness education program). Both active treatment conditions involve a manual-based
behavioral sleep intervention based on CBT for insomnia, provided by allied health
personnel. Baseline data will include subjective and objective measures of sleep, and
structured assessments of depression and quality of life. Post-treatment assessments will
be performed after completion of the 6-week intervention or control conditions, and
follow-up assessments will be performed at 6-months and 12-months follow-up. Main outcome
measures will include sleep/wake patterns (sleep questionnaires and wrist actigraphy),
depression and self-reported quality of life. Data will be analyzed for all randomized
participants in an intention to treat analysis. We hypothesize that compared to control
participants, intervention participants will have improvements in sleep (both objectively
and subjectively) and will report less depressive symptoms and better quality of life at six
months follow-up. We also expect that these improvements will be maintained at 12-months
follow-up.
We found this trial at
1
site
Click here to add this to my saved trials
