MedPath

Intraindividual Variability in Sleep and Cognitive Performance in Older Adults

Phase 2
Completed
Conditions
Insomnia Chronic
Interventions
Behavioral: Brief Behavioral Therapy for Insomnia
Registration Number
NCT02967185
Lead Sponsor
University of Missouri-Columbia
Brief Summary

The proposed study will examine changes in older insomniacs' cognitive functioning following behavioral treatment for insomnia using a combination of two methods. A traditional repeated measures design will be used to look at group level differences based on performance on a neuropsychological battery administered prior to, immediately after, and 3 months after completing a 4 week behavioral treatment program for insomnia. This data will be analyzed using standard repeated measures analytic techniques. A time-series design will also be used to look at within-subject differences based on a brief cognitive battery that will be self-administered on a daily basis. Data from this daily battery will be examined using intraindividual variability modeling.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
62
Inclusion Criteria
  • Age >65 years
  • Community dwelling
  • Available for duration of study
  • Insomnia according to American Sleep Disorders Association (1990) criteria: (a) >30 minutes of unwanted awake time, 3 nights per week for at least 6 months and (b) Daytime dysfunction (reported mood, cognitive, social, or occupational impairment)
Exclusion Criteria
  • Age less than 65
  • history of primary sleep disorder (e.g., sleep apnea, narcolepsy)
  • history of stroke
  • major medical illness known to contribute to sleep problems in last 12 months
  • cognitive impairment that interferes with ability to understand treatment (score <23 on Mini-Mental State Examination)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Brief Behavioral Therapy for InsomniaBrief Behavioral Therapy for InsomniaTreatment will consist of 4 weekly, 1 hour sessions and will be conducted by a trained graduate assistant on an individual basis.
Primary Outcome Measures
NameTimeMethod
Change in diary-assessed total sleep and wake time during sleep from baseline to follow-upfrom baseline to follow-up, approximately 1 year

Participants will complete a daily sleep dairies throughout the study period. They will report their bedtime, waketime, sleep onset latency, and wake time after sleep onset. Total sleep time and total wake time will be calculated from the diaries.

Secondary Outcome Measures
NameTimeMethod
Change in performance on the Mini-Mental Status Examfrom baseline to follow-up, approximately 1 year

Mini-Mental Status Exam (MMSE) (Folstein, Folstein, \& McHugh, 1975)

Change in performance on the Trails A & B (Reitan, 1958)from baseline to follow-up, approximately 1 year

Trails A \& B (Reitan, 1958) was administered

Change in performance on the Boston Naming Test (BNT)from baseline to follow-up, approximately 1 year

Boston Naming Test (BNT)

Change in performance on the Wechsler Memory Scale-3, Logical Memory & Visual Reproduction subtests (WMS-3) Tremblay, 2002)from baseline to follow-up, approximately 1 year
Change in performance on the Controlled Oral Word Associationfrom baseline to follow-up, approximately 1 year

Controlled Oral Word Association (COWA) (Benton \& Hamsher, 1983)

Change in performance on the California Verbal Learning Test (CVLT, CVLT-II)from baseline to follow-up, approximately 1 year

California Verbal Learning Test (CVLT, CVLT-II) (Delis, Kramer, Kaplan, \& Ober, 1987)

Change in actigraphy-assessed sleep variability from baseline to follow-upfrom baseline to follow-up, approximately 1 year

Participants wore an Actiwatch-L (ACTL) (Mini Mitter Co., Inc.) on their non-dominant wrists continuously throughout the study. The sensor of the ACTL is sampled 32 times per second and records peak values for each second. These peak values are then summed into 30-second "activity" counts. These activity counts are downloaded to a personal computer and analyzed using Actiware-Sleep v. 3.3, which uses a validated algorithm to identify periods of as sleep or wake. Total sleep time and total wake time will be computed.

Change in performance on the Rey-Osterreith Complex Figure Test (Rey-O) (Hubley & Tremblay, 2002)from baseline to follow-up, approximately 1 year
Change in performance on Wechsler Adult Intelligence Scale-3, Vocabulary & Digit Symbolfrom baseline to follow-up, approximately 1 year

Wechsler Adult Intelligence Scale-3, Vocabulary \& Digit Symbol (subtests) \[WAIS-3\]

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