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Randomized Controlled Trial
. 2017 Aug 1;40(8):zsx079.
doi: 10.1093/sleep/zsx079.

A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial

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Free PMC article
Randomized Controlled Trial

A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial

Jennifer L Martin et al. Sleep. .
Free PMC article

Abstract

Study objective: To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial.

Methods: Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates.

Results: SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p's < .05). There were no differences in total sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up.

Conclusions: A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC.

Trial registration: ClinicalTrials.gov NCT01259401.

Keywords: adult day health care; aging; behavioral interventions; sleep; veterans.

Figures

Figure 1
Figure 1
Study participant recruitment, screening, and enrollment. ADHC = Adult Day Health Care.
Figure 2
Figure 2
Mean values for actigraphy (ACTI) outcome variables for the Sleep Intervention Program (SIP) and control groups at baseline, post-treatment and 4-month follow-up for sleep efficiency (panel A), number of nighttime awakenings (panel B), total nighttime wake time (panel C) and Total sleep time (panel D). Data presented here includes all available observations for actigraphy at each time point (N = 42 at baseline, N = 38 post-treatment and, N = 38 at 4-month follow-up; also see Supplementary Figures S27–S30 for evaluation of potentially influential data points).

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