Insomnia Chronic
Conditions
Keywords
older Korean Americans, sleep, behavioral approach
Brief summary
Poor sleep is common among Asian Americans. Untreated sleep problems increase the risk of chronic diseases, cognitive decline, and mortality. Cognitive behavioral therapy for insomnia (CBTI) is considered the first-line treatment for chronic sleep problems and has demonstrated significant improvement in sleep health among older adults. However, existing CBTI is built upon Western culture, making it challenging to apply for Asian immigrants who maintain close ties to their native cultures that shape and influence their sleep habits. Addressing the lack of availability of a culturally adapted sleep intervention program is the first step to filling the gap in sleep health disparity among Asian immigrants. This study aims to pilot test the feasibility and the preliminary efficacy of a culturally adapted sleep intervention program among older Korean immigrants with poor sleep, one of the fastest-growing immigrant groups in the United States with limited access to mainstream sleep therapies.
Detailed description
Poor sleep is common among Asian Americans. Untreated sleep problems increase the risk of chronic diseases, cognitive decline, and mortality. Addressing the lack of availability of a culturally adapted sleep intervention program is the first step to filling the gap in sleep health disparity among Asian immigrants. This study aims to evaluate its feasibility and preliminary efficacy of a culturally adapted sleep education program ("SLEEP-OK") in a pilot randomized clinical trial. Study participant (N=32) will be randomized to either our culturally adapted, manual-based sleep intervention group (n=16) or the information-only control group (n=16) at our community partner serving older Korean immigrants. The study will evaluate the feasibility of the intervention and the preliminary effects of the intervention on sleep health outcomes among Korean immigrants at baseline and post-intervention (i.e., immediately after the last session of the intervention).
Interventions
BEHAVIORALCBT-I based sleep intervention
A multicomponent behavioral sleep program, consisting of sleep compression, stimulus control, sleep hygiene, relaxation, daily physical activity, and light exposure
BEHAVIORALSleep Education
This group will receive information about sleep and aging, but without specific or individualized recommendations
Sponsors
University of California, Los Angeles
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Korean immigrants (i.e., being a resident of the United States with a birthplace in Korea) * Able to speak, read, and write in Korean * Aged at least 60 years * Have a score of at least 15 on a Korean version of the Insomnia Severity Index * Able to ambulate with or without an assistive device * Have a score of at least 23 on a Korean version of the Montreal Cognitive Assessment (MoCA) * Score less than 5 on STOP-BANG (or proceed with an additional testing \[Watch Peripheral Arterial Tonometry (WatchPAT) and the Epworth Sleepiness Scale if score is equal to or greater than 5 on STOP-BANG)
Exclusion criteria
* Those who are bedbound * Those who do not meet the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for insomnia disorder * Those who have an untreated apnea-hypopnea index (AHI) at least 15 (moderate obstructive sleep apnea) and Epworth Sleepiness Scale (ESS) at least 11 (indicating mild sleepiness) OR AHI is equal to or greater than 30 (irrespective of ESS)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Sleep Efficiency | Immediately after the last session of the intervention | Nighttime sleep efficiency (i.e., mean percent of time in bed spent asleep at nighttime) will be calculated from 7 consecutive days and nights of wrist actigraphy (Scores range from 0 to 100%, with higher values indicating better objective sleep quality) |
| Subjective Sleep Quality | Immediately after the last session of the intervention | Total score on the Korean version of the Insomnia Severity Index (ISI) will be used as a measure of subjective sleep (Scores range from o to 18, with lower values indicating better subjective sleep quality) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of the Intervention | Immediately after the last session of the intervention | Focus group interviews will be conducted to collect the benefits and challenges of following the sleep intervention program |
Countries
United States
Contacts
CONTACTYeonsu Song, PhD
Outcome results
None listed