A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial.-猫眼课题宝

DOI：

10.1093/sleep/zsx079

发表时间：

2017-08-01

期刊：

Sleep

影响因子：

5.6

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Martin, Jennifer L;Song, Yeonsu;Alessi, Cathy A

研究目的：在一项双盲随机临床试验中，对接受退伍军人管理局成人日间保健(ADHC)计划的老年人进行为期4周的行为睡眠干预计划(SIP：睡眠压缩、改进的刺激控制和睡眠卫生)与为期4周的纯信息对照(IC)的有效性比较。方法：42名参加VA ADHC计划的人(平均年龄：77岁，93%为男性)被随机分为两组。所有患者在基线、治疗后和4个月的随访中完成了面对面的睡眠和健康评估，包括3个日夜的腕部动作图、匹兹堡睡眠质量指数(PSQI)和失眠严重程度指数(ISI)。结果：与IC参与者(n=21)相比，SIP参与者在治疗后的动态睡眠效率(p=.007)、夜间觉醒次数(p=.016)和夜间觉醒分钟数(p=.001)方面均有显著改善。收益略有减弱，但在4个月的随访中仍然显著(均为P&lt；0.05)。两组之间的总睡眠时间没有差异。在4个月的随访中，PSQI因子3(日常障碍)有显著改善(p=.016)，但在治疗后或4个月随访时，两组PSQI的其他成分或ISI评分均无显著差异。结论：短期行为睡眠干预可能对改善ADHC老年人的客观测量睡眠有重要益处。需要进一步的研究来研究这种干预在ADHC内常规临床护理中的实施情况。

Study Objective: 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.Methods: 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.Results: 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.Conclusions: 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.

A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial.

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