Efficacy of Brief Behavioral Treatment for Insomnia in Older Adults: Examination of Sleep, Mood, and Cognitive Outcomes

Author(s)

Christina S. McCrae, University of Missouri-ColumbiaFollow
Ashley F. Curtis, University of Missouri-Columbia
Jacob M. Williams, TIRR Memorial Hermann
Natalie D. Dautovich, Virginia Commonwealth UniversityFollow
Joseph P.H. McNamara, University of Florida
Ashley M. Stripling, Nova Southeastern UniversityFollow
Joseph M. Dzierzewski, Virginia Commonwealth UniversityFollow
Wai Sze Chan, Dartmouth CollegeFollow
Richard B. Berry, University of Florida
Karin J.M. McCoy, South Texans Veterans Health Care SystemFollow
Michael Marsiske, University of FloridaFollow

Document Type

Article

Publication Title

Sleep Medicine

ISSN

1878-5506

Publication Date

11-1-2018

Abstract

OBJECTIVE: The aim of the present study was to examine the effects of a brief behavioral intervention for insomnia (BBTi) on sleep parameters, mood, and cognitive functioning in older adults.

METHODS: Older adults (aged 65 years or more) underwent four weekly sessions of BBTi or self-monitoring control (SMC). Participants completed 14 days of sleep diaries and actigraphy measuring sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), sleep efficiency (SE), and sleep quality ratings at baseline, post-treatment, and three month follow-up. Participants also completed mood scales (Geriatric Depression Scale [GDS]; Beck Depression Inventory-II; and State Trait Anxiety Inventory) and neuropsychological testing (measuring global cognition, language, memory, attention and processing speed, and executive function) at the three timepoints.

RESULTS: Significant condition (BBTi vs. SMC) x time (baseline vs. post-treatment vs. follow-up) interactions revealed that BBTi improved relative to baseline in sleep diary-reported SOL, WASO, SE, and sleep quality, and these improvements were maintained at follow-up. SMC showed no change in these measures. A main effect of time showed that actigraphy-measured WASO improved from baseline for both BBTi and SMC at post-treatment. A main effect of time revealed that both BBTi and SMC patients endorsed fewer GDS symptoms relative to baseline at post-treatment and follow-up. We observed no change in performance on neuropsychological measures.

CONCLUSIONS: A four-week BBTi is an efficacious intervention for reducing insomnia symptoms in older adults. BBTi does not selectively improve mood or cognitive functioning. Future work should examine effects of BBTi on physiological measures of sleep architecture and day-to-day cognition.

CLINICAL TRIAL IDENTIFER: NCT02967185.

DOI

https://doi.org/10.1016/j.sleep.2018.05.018

Volume

51

First Page

153

Last Page

166

PubMed ID

30195661

NSUWorks Citation

McCrae, C. S., Curtis, A. F., Williams, J. M., Dautovich, N. D., McNamara, J. P., Stripling, A. M., Dzierzewski, J. M., Chan, W., Berry, R. B., McCoy, K. J., Marsiske, M. (2018). Efficacy of Brief Behavioral Treatment for Insomnia in Older Adults: Examination of Sleep, Mood, and Cognitive Outcomes. Sleep Medicine, 51, 153-166.
Available at: https://nsuworks.nova.edu/cps_facarticles/1645