Mindfulness Meditation and Insomnia in Alzheimer Disease Caregivers

Recruitment & Eligibility

Inclusion Criteria

Alzheimer or other dementia caregivers
Older than 45 years of age
Self-identified as the principal person taking care of the patient with Alzheimer or other dementia
Diagnostic and Statistical Manual Criteria - 5 for Insomnia

Exclusion Criteria

Psychiatric disorders including current major depressive disorder or other current DSM-5 psychiatric disorder (e.g. substance dependence) with the exception of anxiety disorder;
Psychotic symptoms;
Acute suicidal or violent behavior or history of suicide attempt within the last year
Other sleep disorders including current or lifetime history of sleep apnea, nocturnal myoclonus, phase-shift disorder as identified by SCID-5 and Duke Structured Interview for Sleep Disorders (DSISD)
Medical conditions such as acute or uncontrolled medical illness (e.g., major surgery, metastatic cancer, Class III heart failure, inflammatory disorder)
Chronic infections
Obesity with body mass index (BMI) >35
Use of hormone containing medications including steroids or immune modifying drugs
Daily use of analgesics such as opioids;
Daily us of sedative hypnotic medications
Cognitive impairment as evidenced by DSM-5 interview and/or Mini-Mental Status Exam (MMSE < 26)
Actively practicing a mind body intervention.

Study & Design

Arm && Interventions

Group	Intervention	Description
MAP-I	MAP-I	The Mindful Awareness Practices (MAPs) is a validated and curriculum-based meditation similar to Mindfulness Based Stress Reduction, with the exception that MAPs does not include a day-long retreat or yoga and hence takes a more practical and accessible approach that focuses specifically on the practice of mindfulness and its application in everyday life. (http://marc.ucla.edu) MAP for Insomnia (MAP-I) is a modified version of MAPs that incorporates practice prior to bed, use of practice in the bed during night-time awakenings, and daily body scan.
CBT-I	CBT-I	Cognitive behavioral therapy for insomnia (CBT-I), considered the treatment of choice by the American Academy of Sleep Medicine, combines cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation to improve sleep outcomes, with demonstrated efficacy in adult and older adult populations

Primary Outcome Measures

Name	Time	Method
Insomnia clinical response	One-year	Change in severity of insomnia as measured by the Insomnia Severity Index

Secondary Outcome Measures

Name	Time	Method
Insomnia clinical response	One year	Change in severity of insomnia as measured by clinical diagnosis
Daytime dysfunction	One year	Change in depressed mood as measured by the Inventory of Depressive Symptoms
Inflammation	One year	Change in markers of systemic inflammation as measured by C-reactive protein
Cellular aging	One year	Change in markers of cellular aging as measured by transcriptional profiles of the senescent secretory associated phenotype (SASP)

Recruitment & Eligibility