None listed
Conditions
Brief summary
This pilot study aims to test the feasibility of a non-pharmacological intervention to improve sleep and mood in care partners and people living with dementia. The developed intervention is multimodal and encompasses cognitive behavioural therapy for insomnia (first line of treatment for insomnia), mindfulness-based and fatigue management strategies to holistically target sleep and wellbeing in dyads. 24 dyads of people with dementia and carer partners (n=48) will engage in weekly sessions with a psychologist over six weeks. It is hypothesised that the sleep intervention will demonstrate appropriate: a) acceptability, implementation, and b) preliminary efficacy in reducing symptoms of sleep disturbance, insomnia, daytime impairment and mood disturbance (symptoms of depression and anxiety) and improving quality of life in people living with dementia and their carers from pre- to post-intervention.
Interventions
The developed intervention is therapist-assisted and multimodal, encompassing cognitive behavioural therapy for insomnia (CBT-I), mindfulness and light therapy (seeking natural light upon awakening, avoiding light at night) components to target sleep and mood in dyads of people with dementia and their primary care partner. There will be no use of external light therapy devices (e.g., glasses or light boxes).
Components will include: sleep education, stimulus control, sleep hygiene, strategies f
The developed intervention is therapist-assisted and multimodal, encompassing cognitive behavioural therapy for insomnia (CBT-I), mindfulness and light therapy (seeking natural light upon awakening, avoiding light at night) components to target sleep and mood in dyads of people with dementia and their primary care partner. There will be no use of external light therapy devices (e.g., glasses or light boxes). Components will include: sleep education, stimulus control, sleep hygiene, strategies for fatigue and self-care, seeking or avoiding exposure to bright light, mindfulness (e.g., deep breathing and present-moment focus). The focus of the intervention is on upskilling care partners in using strategies targeting their own sleep, including supporting the sleep of the person they are caring for. For this reason, it will not be required for the person living with dementia to attend all sessions apart from personalised dyad sessions. The group sessions are focused on strategies for care partners with there being the option to attend for the participants living with dementia. • The intervention will consist of personalised dyad-only sessions and group-based delivery. • All sessions will go for 60-90 minutes. Week 1 and 4: personalised dyad-only session; Week 2-3 and 5-6: small group-based sessions of care partners (optional attendance for people living with dementia). Ad hoc email support will be made available. • In the personalised, dyad-only session in Week 1, the interventionist will assess unique sleep concerns of the dyad and deliver core components in light of these circumstances. In Week 4, there will be another personalised dyad-only session to overcome barriers and encourage adherence. The aims of the personalised sessions are to deliver pertinent strategies (e.g., sleep psychoeducation, stimulus control mindfulness), encourage adherence and personalise strategies in light of unique needs. • The intervention will be delivered via Zoom. Personalised dyad-only sessions will focus on psychoeducation about sleep and discussing key strategies. The group sessions will focus on providing a reflective space to discuss strategies and share experiences of implementing strategies with other participants. • It is expected participants will engage in sessions at their shared home. • Sessions will be facilitated by a registered psychologist (minimum two years’ experience delivering CBT-I) and a provisional psychologist with supervision. • Digital handouts (overview and reminders of key strategies) will be provided at the end of each session – these are specifically designed for the study. • Adherence to intervention will be quantitatively (Client Satisfaction Questionnaire, self-rated helpfulness and usefulness of different strategies) and qualitatively (open feedback) assessed at post-intervention and one-month follow-up questionnaires. The psychologist will also check in regarding adherence each session to motivate participants in using strategies.
Sponsors
Monash University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
35 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
PEOPLE LIVING WITH DEMENTIA: a) Living with dementia (any form or severity); b) Receives overnight support from care partner at least 3 times per week c) Can provide informed consent or assent d) Carer-reported sleep concerns (rated on a single-item statement) CARE PARTNERS: a) Self-report issues with their sleep (scores of 5 or more on the Pittsburgh Sleep Quality Index) b) Living with and supporting a person with dementia at least three nights per week (responsible for providing overnight care when needed); c) Able to communicate confidently in English; d) Regular access to phone, email and internet;
Exclusion criteria
PEOPLE LIVING WITH DEMENTIA: a) Living in a residential care home b) Have severe, untreated medical or physical conditions (e.g. emphysema, severe pain) that directly affect sleep c) High risk of harm to self/others CARE PARTNERS: a) Severe untreated medical or physical conditions that directly affect sleep b) Self-reported diagnosis of schizophrenia, bipolar disorder, PTSD) that directly impact sleep; c) Fixed night shiftwork between midnight and 5 am, or rotating work schedules that require night shifts during participation. d) A diagnosis of narcolepsy e) High risk of harm to self/others
Outcome results
None listed