Improving Sleep and Quality of Life in Individuals With Down Syndrome and Their Caregivers
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Objective Sleep Quality - Sleep duration
Study Overview
Brief Summary
Aim 1 of the proposed project will be to adapt the virtual Mindfulness-Based Therapy for Insomnia (MBTI) for individuals with Down syndrome (DS). The investigators will work closely with a community advisory board consisting of individuals with DS, their caregivers, and clinicians specializing in DS and sleep medicine to ensure that the intervention protocol is relevant and appropriate for young people with DS (age 12 and older). Planned adaptations include 1) utilization of visual aids and videos to increase engagement and reinforce mindfulness concepts and practices; 2) shortened meditation practices to accommodate concentration limits of individuals with DS; 3) caregiver involvement reflecting the important role of caregivers in daily functioning of individuals with DS; 4) adapted homework to cater to the learning styles of individuals with DS; 5) daily reminders to encourage regular practice and reinforce the importance of consistency; and 6) modified session structure to ensure that participants are able to discuss their experiences and refine their mindfulness practice. During the first 6 months of the project, the investigators will meet monthly with the community advisory board and use an iterative process to develop detailed intervention protocol for a virtual MBTI suitable for young people with DS.
Aim 2 of the project will be to pilot test the efficacy of the virtual MBTI for young people with DS. In the second half of the one-year project, the investigators will conduct a pilot randomized clinical trial (RCT) of the intervention developed in Aim 1.
This project will compare the effectiveness of Mindfulness Based Therapy for Insomnia (MBTI) and Brief Behavioral Therapy for Insomnia (BBTI) for young people with Down syndrome (DS). The interventions will be compared on their impact on improving sleep problems, quality of life, and functional outcomes. This project will also test if targeting the sleep of the caregiver in addition to the individual with Down syndrome has any effect on the outcomes.
Detailed Description
This study aims to address the significant gap in effective behavioral treatments for sleep problems in individuals with Down syndrome (DS). Specifically, it focuses on testing the efficacy of a virtual Mindfulness-Based Therapy for Insomnia (MBTI) for individuals with DS aged 12-30 years, along with their caregivers. The intervention seeks to improve sleep quality and overall quality of life for both participants and their caregivers.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 12 Months to 30 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Individuals with a confirmed diagnosis of Down syndrome (DS).
- •English is the primary language spoken in the household.
- •Nonverbal mental age of at least 36 months, as determined by a baseline measure of adaptive skills.
- •Presence of at least one sleep disturbance occurring five or more nights per week, as reported by a caregiver. Sleep disturbances may include: Bedtime resistance; Delayed sleep onset; Problematic sleep associations; Nighttime awakenings; Early morning awakenings
Exclusion Criteria
- •Severe sensory or motor impairments that would interfere with participation in the intervention.
- •Inability to complete assessments or participate in the intervention sessions due to behavioral or medical conditions.
- •Participation in other concurrent behavioral or sleep interventions.
- •Caregiver inability or unwillingness to provide accurate reports or assist in intervention activities as needed.
Arms & Interventions
Mindfulness-Based Therapy for Insomnia
Individuals with Down syndrome will receive the MBTI intervention over 8 sessions lasting 1 hour over 8 weeks (one session per week). One trained graduate research assistant will deliver the intervention with supervision of a licensed Clinical Psychologist.
Intervention: Mindfulness-Based Therapy for Insomnia (Behavioral)
Wait-list control
The control group will do the pre and post assessments but will not be part of any intervention. The wait-list control group will receive the MBTI intervention after the post-intervention measures are completed.
Intervention: Wait-list control (Behavioral)
Outcomes
Primary Outcomes
Objective Sleep Quality - Sleep duration
Time Frame: Before (week 0) and at week 9 (the end of the 8-week intervention period).
Assessed using wearable devices (FitBit Versa 4), which record sleep parameters: Sleep duration (in hours). Sleep duration in hours will be averaged over seven consecutive days, before and after the 8-week intervention. Higher scores indicate better outcome.
Objective Sleep Quality - Sleep efficiency
Time Frame: Before (week 0) and at week 9 (the end of the 8-week intervention period).
Assessed using wearable devices (FitBit Versa 4), which record sleep parameters: Sleep efficiency (percentage of time spent asleep while in bed). Higher scores indicate better outcome.
Objective Sleep Quality - Number of night awakenings
Time Frame: Before (week 0) and at week 9 (the end of the 8-week intervention period).
Assessed using wearable devices (FitBit Versa 4), which record sleep parameters: Number of night awakenings (count for night awakenings)
Subjective Sleep Quality - Children's Sleep Habits Questionnaire
Time Frame: Before (week 0) and at week 9 (the end of the 8-week intervention period).
Measured using standardized parent-reported questionnaires: \- Children's Sleep Habits Questionnaire (CSHQ): Assesses sleep behaviors and patterns. The CSHQ is a retrospective, 45-item parent questionnaire. Scale Range: 45-135. Higher scores indicate worse sleep quality. Unit of Measure: Raw score
Subjective Sleep Quality - Insomnia Severity Index
Time Frame: Before (week 0) and at week 9 (the end of the 8-week intervention period).
\- Insomnia Severity Index (ISI): Measures the severity of insomnia symptoms. Scale Range: 0-28. Higher scores indicate worse insomnia severity.
Secondary Outcomes
- Quality of life - Caregiver report(Before (week 0) and at week 9 (the end of the 8-week intervention period).)
- Quality of life(Before (week 0) and at week 9 (the end of the 8-week intervention period).)
Investigators
Caroline G. Richter
Assistant Professor
University of Alabama at Birmingham