Efficacy of brief behavioral treatment for insomnia in older adults: examination of sleep, mood, and cognitive outcomes

Study Objectives: The goal of this study was to examine daily associations between sleep and cognition in older adults suffering from insomnia, with or without a history of chronic pain. Methods: Sixty older adults with insomnia and a history of chronic pain (HxCP; n = 33, mean age = 69.5 years, standard deviation = 7.8) or no history of chronic pain (NCP; n = 27, mean age = 69.7 years, standard deviation = 7.9) completed 14 days of diaries and actigraphy, measuring sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), and sleep quality. Participants completed daily cognitive measures of processing speed (ie, symbol digit modalities test, SDMT), reasoning (ie, letter series), and verbal memory (ie, word list delayed recall). For HxCP and NCP, associations between sleep parameters, daily pain, depressive symptoms (ie, Beck Depression Inventory, Second Edition scores), and daily cognition, controlling for age, and global cognition were examined through multilevel modeling. Results: For HxCP, greater self-reported WASO was associated with worse next-day SDMT performance, whereas greater actigraphic WASO was associated with better next-day SDMT performance. Greater depression was associated with worse daily letter series performance. Greater self-reported WASO and SE were associated with better next-day delayed recall. For NCP, greater self-reported WASO and depression were associated with better daily SDMT performance, whereas worse daily pain was associated with worse SDMT and delayed recall performance. Conclusions: In older adults with HxCP, improving sleep may benefit lower level cognition, whereas reducing depression may affect higher level cognition. Discrepancies in sleep parameters promote assessment of objective and subjective sleep outcomes when investigating effects of insomnia on cognition.

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“…Additional details on sleep diaries are provided in the previously published clinical trial outcomes manuscript. 21…”

Section: Sleep Diariesmentioning

confidence: 99%

Chronic Pain, Sleep, and Cognition in Older Adults With Insomnia: A Daily Multilevel Analysis

Curtis

Williams

McCoy

et al. 2018

Journal of Clinical Sleep Medicine

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“…Insomnia, or lack of sleep with difficulty in initiating sleep and/or staying asleep throughout the night and/or possible early morning awakenings, is a concept that has been studied in a number of disciplines including psychology (e.g., McCurry, Logsdon, Teri, and Vitiello, 2007), nursing (e.g., Brandt & Piechocki, 2013), and medicine (e.g., Buenaver, Townnsend, & Ong, 2019;McCrae et al, 2018). Various disciplines including nursing have been interested in issues surrounding sleep because of the hypothesized connection with health outcomes (Sandlund, Hetta, Nilsson, Ekstedt, & Westman, 2017).…”

Section: Insomniamentioning

confidence: 99%

Feasibility of an online cognitive behavioral therapy program to improve insomnia, mood, and quality of life in bereaved adults ages 55 and older

2021

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“…Consequently, BBTi typically consists of sleep education, stimulus control, and sleep restriction. Older adults receiving BBTi show significant reductions in sleep onset, wake after sleep onset, sleep efficiency, and sleep quality compared to individuals in a self-monitoring control group [56]. However, the same study found that individuals receiving BBTi reported similar levels of depressive symptoms following treatment as older adults in the control condition and no changes in cognitive functioning.…”

Section: Psychological Treatment Options For Late-life Insomniamentioning

confidence: 99%

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

Dzierzewski

Griffin

Ravyts

et al. 2018

Curr Sleep Medicine Rep

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Purpose of Review: Late-life insomnia is a serious medical condition associated with many untoward consequences. The high prevalence of late-life insomnia, along with the concomitant risks inherent in the use of hypnotic medications in older adults necessitates non-pharmacological (i.e., psychological) treatment options. We aim to summarize and evaluate the state-of-the-science of psychological treatment options for late-life insomnia. Recent Findings: Cumulative scientific evidence suggests the efficacy of psychological treatment of late-life insomnia. During the previous decade, trials of psychological treatments for insomnia have begun to test various modifications to treatments that have the potential to improve access for older adults, along with expanding their focus to include individuals with comorbid conditions that are common to older adults. While these modifications represent positive advances in the science of treatment for late-life insomnia, the evidence is still largely explanatory/efficacious in nature. Summary: Psychological strategies represent the best approaches for the treatment of late-life insomnia. Future investigations would be wise to progressively move towards increasingly pragmatic/effectiveness investigations, adding to the literature base regarding the treatment of late-life insomnia under usual/real-world conditions as opposed to ideal/artificial conditions.

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Efficacy of brief behavioral treatment for insomnia in older adults: examination of sleep, mood, and cognitive outcomes

Abstract: NCT02967185.

Cited by 49 publications

References 84 publications

Chronic Pain, Sleep, and Cognition in Older Adults With Insomnia: A Daily Multilevel Analysis

Chronic Pain, Sleep, and Cognition in Older Adults With Insomnia: A Daily Multilevel Analysis

Feasibility of an online cognitive behavioral therapy program to improve insomnia, mood, and quality of life in bereaved adults ages 55 and older

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

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