University of Virginia, School of Nursing, Charlottesville, VA, USA.
University of Virginia, School of Medicine, Charlottesville, VA, USA.
J Alzheimers Dis. 2021;84(4):1539-1550. doi: 10.3233/JAD-210657.
Approximately 50% of older adults with cognitive impairment suffer from insomnia. When untreated, pre-existing cognitive problems may be exacerbated and potentially contribute to further cognitive decline. One promising approach to maintain cognitive health is to improve sleep quantity and quality.
To determine feasibility, acceptability, and preliminary efficacy of Sleep Health Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness (SHUTi OASIS), an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) program in older adults with mild cognitive impairment (MCI).
Older adults with MCI and insomnia were recruited from hospital-based memory and sleep disorders clinics and enrolled in a single-arm pilot study. Participants completed the six cores of SHUTi OASIS, over nine weeks with two-week baseline and post-assessments using self-reported sleep diaries. Feasibility and acceptability were informed by usage statistics and qualitative interviews; preliminary efficacy was informed by patient-generated sleep data.
Twelve participants enrolled and, on average, were 75.8 years of age. Ten participants completed the study and logged in most days. Most participants reported a positive overall experience, and interviews revealed successful and independent program management and completion. There were significant changes on all baseline to post-assessment sleep measures, including clinically meaningful improvements on the Insomnia Severity Index (13.5 to 8.3, p < 0.01), sleep efficiency, wake after sleep onset, and sleep onset latency (ps < 0.02). There was no statistically significant change in cognitive measures (p > 0.05).
This study supports that older adults with cognitive impairment can independently complete CBT-I via the Internet and achieve clinical sleep improvements.
约 50%有认知障碍的老年人患有失眠症。如果不进行治疗，现有的认知问题可能会加剧，并可能导致进一步的认知能力下降。保持认知健康的一种很有前途的方法是提高睡眠的数量和质量。
评估针对患有失眠和睡眠障碍的老年认知障碍患者的互联网睡眠健康（SHUTi OASIS）的可行性、可接受性和初步疗效，这是一种针对轻度认知障碍（MCI）老年人的互联网认知行为疗法失眠（CBT-I）方案。
从医院的记忆和睡眠障碍诊所招募了患有 MCI 和失眠症的老年人，并将他们纳入一项单臂试点研究。参与者完成了 SHUTi OASIS 的六个核心内容，为期九周，有两周的基线和后评估，使用自我报告的睡眠日记。使用使用情况统计数据和定性访谈来评估可行性和可接受性；使用患者生成的睡眠数据来评估初步疗效。
12 名参与者入组，平均年龄为 75.8 岁。10 名参与者完成了研究并每天登录。大多数参与者报告了积极的整体体验，访谈揭示了成功和独立的项目管理和完成。所有基线到后评估的睡眠指标都有显著变化，包括失眠严重程度指数（从 13.5 降至 8.3，p<0.01）、睡眠效率、睡眠后觉醒和入睡潜伏期显著改善（p<0.02）。认知指标没有统计学上的显著变化（p>0.05）。
这项研究支持认知障碍的老年人可以独立通过互联网完成 CBT-I，并实现临床睡眠改善。
