Martin Jennifer L, Song Yeonsu, Hughes Jaime, Jouldjian Stella, Dzierzewski Joseph M, Fung Constance H, Rodriguez Tapia Juan Carlos, Mitchell Michael N, Alessi Cathy A
Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA.
David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA.
Sleep. 2017 Aug 1;40(8). doi: 10.1093/sleep/zsx079.
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.
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.
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.
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.
在一项双盲、随机临床试验中，比较为期4周的行为睡眠干预项目（SIP：睡眠压缩、改良刺激控制和睡眠卫生）与为期4周的仅提供信息的对照项目（IC），对参加退伍军人事务部（VA）成人日间保健（ADHC）项目的老年人的有效性。
42名参加VA ADHC项目的个体（平均年龄：77岁，93%为男性）被随机分配接受SIP或IC。所有人在基线、治疗后和4个月随访时完成了面对面的睡眠和健康评估，包括3天/晚的手腕活动监测、匹兹堡睡眠质量指数（PSQI）和失眠严重程度指数（ISI）。采用混合重复测量分析比较治疗后和4个月随访时的睡眠结果，将基线值作为协变量。
与IC组参与者（n = 21）相比，SIP组参与者（n = 21）在治疗后，在活动监测睡眠效率（p = .007）、夜间觉醒次数（p = .016）和夜间清醒分钟数（p = .001）方面有显著改善。在4个月随访时，益处略有减弱，但仍具有显著性（所有p值 < .05）。两组之间的总睡眠时间没有差异。在4个月随访时，PSQI因子3（日常干扰）有显著改善（p = .016），但在治疗后或4个月随访时，SIP组和IC组在其他PSQI成分或ISI评分上没有差异。
简短的行为睡眠干预可能对改善参加ADHC的老年人的客观测量睡眠有重要益处。未来需要开展研究，以探讨将这种干预措施纳入ADHC常规临床护理的实施情况。
