Behavioral Intervention for Insomnia: Future Directions for Nontraditional Caregivers at Various Stages of Care

McCrae, Christina S.; Tierney, Candece G.; McNamara, Joseph P. H.

doi:10.1300/j018v29n02_10

Cited by 12 publications

(13 citation statements)

References 23 publications

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“…When an ABA intervention withdrawal design is used, behaviour is monitored at baseline, after the implementation of the intervention and after the completion of the intervention. Twelve studies identified in the review used an ABA design to evaluate the impact of interventions on treatment adherence (Cortina, Somers, Rohan, & Drotar, 2013;Daughters, Magidson, Schuster, & Safren, 2010;Gray, Janicke, Fennell, Driscoll, & Lawrence, 2011;Payne, Eaton, Mee, & Blount, 2013;Penica & Williams, 2008), physical activity (Casey, Mackay-Lyons, Connolly, Jennings, & Rasmussen, 2014;Lowe, Watanabe, Baracos, & Courneya, 2013), drug and alcohol use (Norberg, Perry, Mackenzie, & Copeland, 2014;Wright & Thompson, 2002), eating behaviour (Hill, Masuda, Moore, & Twohig, 2015), smoking (Banducci, Long, & MacPherson, 2015) and sleep behaviour (McCrae, Tierney, & McNamara, 2005). For example, McCrae et al (2005) delivered a behavioural intervention designed to improve sleep quantity and quality in four caregivers.…”

Section: Interventional N-of-1 Designmentioning

confidence: 99%

“…A number of important features are considered when using visual analysis to identify the presence of a functional relationship between predictor and outcome variables including changes in level (i.e., average), slope (i.e., trend), variability, immediacy of effect, overlap between phases and consistency of data in similar phases (Chen, Peng, & Chen, 2015). Studies identified in the review using visual analysis examined changes in level across phases (Bernard et al, 2009;Cervantes & Porretta, 2013;Cohen et al, 2002;Gorczynski et al, 2008;Gorski et al, 2005;Gray et al, 2011;Hill et al, 2015;Lee et al, 2014;MacPherson et al, 2016;McCrae et al, 2005;Norberg et al, 2014;Payne et al, 2013;Penica & Williams, 2008;Piven & Duran, 2014;Romero, 2010;Sevick et al, 2005;Smith, 2012b;Sonnier, 2002;Soroudi et al, 2008;Ward et al, 2010;Yngman-Uhlin et al, 2012). Five studies also examined changes in slope across phases (Gorczynski et al, 2008;Gray et al, 2011;Payne et al, 2013;Smith, 2012b;Vail-Gandolfo, 2009), two studies examined the latency of the intervention effect (Gorczynski et al, 2008;Smith, 2012b) and one examined overlap in data points across different phases (Gorczynski et al, 2008).…”

Section: Analysing N-of-1 Researchmentioning

confidence: 99%

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The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: a systematic literature overview

McDonald

Quinn

Vieira

et al. 2017

Health Psychology Review

172

114

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n-of-1 studies test hypotheses within individuals based on repeated measurement of variables within the individual over time. Intra-individual effects may differ from those found in between-participant studies. Using examples from a systematic review of n-of-1 studies in health behaviour research, this article provides a state of the art overview of the use of n-of-1 methods, organised according to key methodological considerations related to n-of-1 design and analysis, and describes future challenges and opportunities. A comprehensive search strategy (PROSPERO:CRD42014007258) was used to identify articles published between 2000 and 2016, reporting observational or interventional n-of-1 studies with health behaviour outcomes. Thirty-nine articles were identified which reported on n-of-1 observational designs and a range of n-of-1 interventional designs, including AB, ABA, ABABA, alternating treatments, n-of-1 randomised controlled trial, multiple baseline and changing criterion designs. Behaviours measured included treatment adherence, physical activity, drug/alcohol use, sleep, smoking and eating behaviour. Descriptive, visual or statistical analyses were used. We identify scope and opportunities for using n-of-1 methods to answer key questions in health behaviour research. n-of-1 methods provide the tools needed to help advance theoretical knowledge and personalise/tailor health behaviour interventions to individuals.

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Section: Interventional N-of-1 Designmentioning

confidence: 99%

Section: Analysing N-of-1 Researchmentioning

confidence: 99%

The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: a systematic literature overview

McDonald

Quinn

Vieira

et al. 2017

Health Psychology Review

172

114

View full text Add to dashboard Cite

show abstract

“…12 We investigated whether caregivers' actigraphic estimates of sleep parameters (ie, time in bed, sleeponset latency, and sleep efficiency) were associated with a measure of caregiver depression and measures of caregiver burden (ie, duration of caregiving, care recipient cognitive status, care recipient nocturnal behavior problems). We also examined whether actigraphic estimates of sleep were associated with age and health status.…”

mentioning

confidence: 99%

“…In addition, researchers have suggested that duration of caregiving could also be an important correlate of caregivers' objective sleep quality because increased experience in the caregiver role and the challenges associated with different stages of care could influence the level of stress experienced and sleep quality among caregivers. 12 We investigated whether caregivers' actigraphic estimates of sleep parameters (ie, time in bed, sleeponset latency, and sleep efficiency) were associated with a measure of caregiver depression and measures of caregiver burden (ie, duration of caregiving, care recipient cognitive status, care recipient nocturnal behavior problems). We also examined whether actigraphic estimates of sleep were associated with age and health status.…”

mentioning

confidence: 99%

The Relationship Between Objectively Measured Sleep Disturbance and Dementia Family Caregiver Distress and Burden

Beaudreau

Spira

Gray

et al. 2008

J Geriatr Psychiatry Neurol

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The aim of this study was to determine whether distress and burden were associated with objective measures of sleep disturbance in dementia caregivers. Using wrist actigraphy, sleep was measured in 60 female, Caucasian dementia family caregivers (mean age, 64.8 years). Caregivers completed questionnaires about demographics, health, depression, duration of caregiving and care recipient nighttime behavior. Care recipients completed a mental status exam. We investigated whether these measures were associated with actigraphic sleep parameters. Greater depressive symptoms among caregivers were associated with poorer sleep efficiency. Older caregiver age and poorer self-rated health were associated with longer time in bed. Sleep disturbance, which is common among dementia caregivers, might be an important index of caregiver distress (ie, depression) but might not be associated with burden (based on the care recipient's general cognitive impairment or nighttime awakenings.).

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“…As the responsibilities and stressors of the caregiving role can both precipitate and perpetuate insomnia [ 5 ], caregivers are up to 3 times more likely to report sleep disturbances than the general population (up to 90% vs approximately 33%-50%, respectively) [ 6 , 7 ]. Cognitive behavioral therapy for insomnia (CBT-I), the gold standard treatment for insomnia [ 6 ], has shown promise among caregivers; however, their uptake and completion of this therapy has been limited [ 8 - 10 ]. As such, directly assessing how the caregiving context affects CBT-I engagement and efficacy could help to ensure that caregivers have equitable access to and benefit from this evidence-based intervention.…”

Section: Introductionmentioning

confidence: 99%

Single-Group Trial of an Internet-Delivered Insomnia Intervention Among Higher-Intensity Family Caregivers: Rationale and Protocol for a Mixed Methods Study

Shaffer¹,

Ritterband²,

You³

et al. 2022

JMIR Res Protoc

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Background Family caregivers are more likely to experience insomnia relative to noncaregivers but have significant barriers to accessing gold standard cognitive behavioral therapy for insomnia treatment. Delivering interventions to caregivers through the internet may help increase access to care, particularly among higher-intensity caregivers who provide assistance with multiple care tasks over many hours per week. Although there are existing internet interventions that have been thoroughly studied and demonstrated as effective in the general population, the extent to which these interventions may be effective for caregivers without tailoring to address this population’s unique psychosocial needs has not been studied. Objective The goal of this trial is to determine what tailoring may be necessary for which caregivers to ensure they receive optimal benefit from an existing evidence-based, internet-delivered cognitive behavioral therapy for insomnia program named Sleep Healthy Using the Internet (SHUTi). Specifically, we will test the association between caregivers’ engagement with SHUTi and their caregiving context characteristics (ie, caregiving strain, self-efficacy, and guilt) and environment (ie, proximity to care recipient; functional status, cognitive status, and problem behavior of care recipient; and type of care provided). Among caregivers using the program, we will also test the associations between change in known treatment mechanisms (sleep beliefs and sleep locus of control) and caregiving context factors. Methods A total of 100 higher-intensity caregivers with significant insomnia symptoms will be recruited from across the United States to receive access to SHUTi in an open-label trial with mixed methods preassessments and postassessments. At postassessment (9 weeks following preassessment completion), participants will be categorized according to their engagement with the program (nonusers, incomplete users, or complete users). Study analyses will address 3 specific aims: to examine the association between caregivers’ engagement with SHUTi and their caregiving context (aim 1a); to describe caregivers’ barriers to and motivations for SHUTi engagement from open-ended survey responses (aim 1b); and among caregivers using SHUTi, to determine whether cognitive mechanisms of change targeted by SHUTi are associated with differences in caregiving context (aim 2). Results Institutional review board approvals have been received. Data collection is anticipated to begin in December 2021 and is expected to be completed in 2023. Conclusions Findings will inform the next research steps for tailoring and testing SHUTi for optimal impact and reach among caregivers. Beyond implication to the SHUTi program, the findings will be translatable across intervention programs and will hold significant promise to reduce inefficiencies in developing digital health interventions for caregivers while also increasing their impact and reach for this underserved population. Trial Registration ClinicalTrials.gov; NCT04986904; https://clinicaltrials.gov/ct2/show/NCT04986904?term=NCT04986904 International Registered Report Identifier (IRRID) PRR1-10.2196/34792

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Behavioral Intervention for Insomnia: Future Directions for Nontraditional Caregivers at Various Stages of Care

Cited by 12 publications

References 23 publications

The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: a systematic literature overview

The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: a systematic literature overview

The Relationship Between Objectively Measured Sleep Disturbance and Dementia Family Caregiver Distress and Burden

Single-Group Trial of an Internet-Delivered Insomnia Intervention Among Higher-Intensity Family Caregivers: Rationale and Protocol for a Mixed Methods Study

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