Aging Well, Sleeping Efficiently: Intervention Studies

描述(申请人提供)：该计划项目(“老年”)的总体目标是确定是否可以通过旨在改善正常老年人睡眠的行为干预措施来改善他们的生活、健康和福祉。大多数老年人面临着日常生活的方方面面，如失去亲人、需要照顾生病的配偶、与身体健康相关的失眠以及进入生命的最后几年；所有这些都会对他们的睡眠、健康、幸福、情绪和功能能力构成挑战。有三个核心：管理和学科招聘(Monk)、数据收集(Buysse)和数据分析(Mazumdar)，以及五个组成部分项目(见下文)，所有这些项目都使用共享的一组措施(Agebat)，从而允许对整个计划的假设进行测试。Agebat变量分为三个广泛的(有时是重叠的)类别：筛查措施、预测/结果措施以及关键的主持人和调解人。领域包括：睡眠、活动和昼夜节律功能、心理健康、身体健康、认知功能、一般功能、心理社会和压力，以及人口统计学。项目1(Monk)旨在确定是否可以通过社会节奏疗法来改善新近丧偶的老年人(65岁)的生活，在社会节奏疗法中，生活方式的规律性得到提高，并遵循健康的睡眠习惯。项目2(Hall)关注早期阿尔茨海默病患者的配偶照顾者(65岁)，以及一项旨在改善他们的睡眠和减轻护理压力的干预措施。项目3(Buysse)旨在比较失眠的简短行为治疗与仅有信息控制条件的患者(65岁)在初级保健环境中常见的衰老疾病中的疗效。项目4(雷诺)将测试限制卧床时间(30分钟)和健康睡眠实践教育的有效性，以此作为维持或改善高龄(75岁)人睡眠质量的一种手段，从而增强他们的白天警觉性、情绪、认知功能和幸福感。项目5(Nofzinger)试图在健康老年人(75y)中确定伴随年龄相关变化和干预相关睡眠变化的睡眠相关功能性神经解剖学变化。比较将在24个月的时间内在受试者内进行，在来自项目4的干预和对照老年人之间，以及在单独研究的老年人和年轻人之间。所有干预项目将不仅关注干预对睡眠本身的影响，而且还将使用中介模式关注随后的心理健康、身体健康、福祉和功能。计划范围内的研究活动将关注压力(光环)、生活方式规律性(Monk)、与身体健康不良相关的失眠(Buysse)和卧床时间(Reynolds)在混合老年人群中的具体作用。同样，研究结果将在将睡眠与健康、功能和幸福感联系起来的概念模型中进行解释。

DESCRIPTION (provided by applicant): The overall aim of this program project ("AgeWise") is to determine whether the lives, health and well-being of normal elderly people can be improved by behavioral interventions designed to enhance their sleep. Most seniors are faced with aspects of their everyday lives such as bereavement, the need to care for an ailing spouse, insomnia related to physical ill-health and progression into the final years of life; all of which can present challenges both to their sleep, and to their health, well-being, mood and ability to function. There are three cores: Administration and Subject Recruitment (Monk), Data Collection (Buysse), and Data Analysis (Mazumdar), and five component projects (see below) all using a shared battery of measures (Agebat), allowing for program-wide hypotheses to be tested. Agebat variables are divided into three broad (sometimes overlapping) categories: screening measures, predictor/outcome measures, and key moderators and mediators. Domains include: sleep, activity and circadian function, mental health, physical health, cognitive functioning, general functioning, psychosocial and stress, and demographics. Project 1 (Monk) seeks to determine whether the lives of recently widowed seniors (65y+) can be improved by Social Rhythm Therapy in which lifestyle regularity is increased and healthy sleep practices followed. Project 2 (Hall) is concerned with spousal caregivers (65y+) of early Alzheimer patients and an intervention designed to enhance their sleep and reduce the stress of caregiving. Project 3 (Buysse) aims to compare the efficacy of a brief behavioral treatment for insomnia to an information-only control condition in patients (65y+) with the usual morbidities of aging seen in primary care settings. Project 4 (Reynolds) will test the efficacy of restricting time in bed (by 30 minutes) plus education in healthy sleep practices as a means of maintaining or improving sleep quality in the very old (75y+) and thus enhancing their daytime alertness, mood, cognitive function, and well being. Project 5 (Nofzinger) seeks to identify sleep-related functional neuroanatomic changes that accompany age-related changes and intervention related changes of sleep in healthy elders (75y+). Comparisons will be made within-subjects over a 24 month span, between intervention and control seniors from Project 4, and between seniors and younger adults studied separately. All of the intervention projects will be concerned not only with the effects of the intervention on sleep per se, but also with subsequent mental health, physical health, well-being and functioning using a mediational model. Program-wide research initiatives will be concerned with the specific roles of stress (Halo, lifestyle regularity (Monk), insomnia related to physical ill-health (Buysse), and time spent in bed (Reynolds) on a mixed population of seniors. Again results will be interpreted within a conceptual model linking sleep to health, functioning and well-being.