Sleep Initiation and Maintenance Disorders
Conditions
Keywords
Sleep Initiation and Maintenance Disorders, Behavior Therapy
Brief summary
The purpose of the study was to evaluate and compare the efficacy of single interventions (stimulus control instructions, sleep restriction therapy) and multi-component intervention (stimulus control instructions and sleep restriction therapy) for chronic insomnia in community dwelling older adults. The subjects were randomly assigned to one of four conditions: stimulus control instructions, sleep restriction therapy, multi-component treatment (stimulus control instructions and sleep restriction therapy), or measurement control.
Interventions
BEHAVIORALstimulus control therapy, sleep restriction therapy, multi-component treatment (stimulus control therapy, sleep restriction therapy)
Treatment was given weekly for 6 weeks. Sessions 1 - 4 were in a group format. Session 5 & 6 were delivered individually by phone.
Sponsors
Carl T. Hayden VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 55 years or older * Sleep onset or maintenance insomnia of 45 minutes or more per night for at least 3 nights per week as ascertained through 14 days of sleep diaries * Insomnia duration of at least 6 months * Impaired daytime functioning as a consequence of insomnia
Exclusion criteria
* Psychopathology evidenced by the Brief Symptom Inventory Global Severity Index T score \>60 * Cognitive impairment as ascertained by the Mini-Mental State Exam score \< 27 * Current psychotherapy or medical treatment for major depression or other psychopathology * Current and regular use of over-the-counter medication or prescription medication for sleep (verified through urinalysis), or any medication affecting sleep * Major physical or mental illness directly related to the onset and course of insomnia * Substance abuse problem ascertained per interview * Suspicion of sleep apnea as determined by an Epworth Sleepiness Scale score of 11 or greater, a respiratory disturbance index of \> 15 as established through in-home overnight use of the EdenTec Model 3711 Digital Recorder, and interview with a significant other, if available * Restless leg syndrome, periodic limb movement disorder, or circadian rhythm sleep disorders as determined through the participant interview and an interview with a significant other, if available.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| subjective sleep | 1 year | daily sleep diaries were used for 2 weeks at each of the four measurement points, pre-treatment, post-treatment, 3 months and 1 year - called daily to voice mail service to avoid retrospective estimates of sleep |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| insomnia severity | 1 year | Insomnia Severity Index was used at the four measurement points (pre-treatment, post-treatment, 3 months, and 1 year) and also included the significant other version of the instrument |
Outcome results
None listed