REDUCING STRESS AND SLEEP DISTURBANCES IN CAREGIVERS OF ALZHEIMER'S PATIENTS

生育压力与许多不良健康后果有关，包括精神病发病率、免疫系统失调、对疾病和疾病的易感性增加以及死亡风险增加。睡眠问题在护理人员中很常见，与压力相关的睡眠中断可能是对睡眠不良健康后果的脆弱性的信号，或者在睡眠不良健康后果中发挥因果作用。这项修订后的研究的总体目的是测试干预措施的有效性，旨在减少压力和改善阿尔茨海默病（AD）患者的配偶照顾者的样本中的睡眠。将干预与仅注意力控制条件进行比较。 本研究的具体目的是：1.描述AD患者配偶照顾者的压力相关睡眠中断。2.测试压力管理+健康睡眠实践（SM+HSP）干预对改善AD照顾者睡眠和健康结局的短期疗效。3.检测SM+HSP在AD照顾者中的持久性。该研究将包括60名AD患者的配偶照顾者，他们将被随机分配到两种治疗条件之一。SM+HSP干预将包括每周八次的家庭会议，重点是信息支持，技能培训，情感自我管理和健康睡眠实践。单独来看，这些成分已被证明可有效减轻AD护理人员的压力或改善主观睡眠投诉。控制条件将包括每周八次的家庭会议，重点是饮食和食物摄入。将通过录音带记录监测治疗完整性。将在4个时间点进行项目测量组合（BABAT）和特定于BABAT的其他测量：随机化前、干预后即刻以及6个月和12个月随访访视。具体项目的数据将用于评估治疗效果和护理人员压力与睡眠之间的关系。压力，睡眠和健康之间的关系将使用项目1-5中收集的全项目数据进行更全面的评估。 我们的项目范围的目标是：描述与压力相关的睡眠中断对老年人健康的影响，包括AD 护理人员、新近丧偶者、初级保健机构中的失眠患者以及75岁以上的健康老年人。在个人项目中要测试的主要假设是，工作压力对睡眠有不利影响，而与压力相关的睡眠中断反过来会对健康和福祉产生负面影响。据推测，相对于仅注意力控制条件，主动干预（SM+HSP）将导致睡眠的改善以及随后的健康和幸福感的改善。

The stress of caregiving is associated with a number of adverse health outcomes including psychiatric morbidity, immune system dysregulation, increased susceptibility to illness and disease, and increased risk for mortality. Sleep complaints are common among caregivers, and stress-related sleep disruptions may signal vulnerability to, or play a causal role in, the adverse health consequences of caregiving. The general aim of this revised study is to test the efficacy of an intervention designed to reduce stress and improve sleep in a sample of spousal careqivers of patients with Alzheimer Disease (AD). The intervention will be compared to an attention-only control condition. Specific aims of this study are: 1. To characterize stress-related sleep disruptions in spousal caregivers of AD patients. 2. To test the short-term efficacy of a stress management+healthy sleep practices (SM+HSP) intervention for improving sleep and health outcomes in AD caregivers. 3. To test the durability of SM+HSP in AD caregivers. The study will include 60 spousal caregivers of AD patients who will be randomly assigned to one of two treatment conditions. The SM+HSP intervention will consist of eight weekly in-home sessions that will focus on information support, skills training, affective self-management, and healthy sleep practices. Individually, these components have been shown to be efficacious for reducing stress or improving subjective sleep complaints in AD caregivers. The control condition will include eight weekly in-home sessions which will focus on diet and food intake. Treatment integrity will be monitored by audiotape recordings. The program project measures battery (Agebat) and additional measures specific to caregiving will be administered at four time points: prior to randomization, immediately post-intervention, and at 6- and 12-month follow-up visits. Project -specific data will be used to evaluate treatment efficacy and relationships among caregiver stress and sleep. Relationships among stress, sleep, and health will be more fully evaluated using program-wide data collected in Project 1-5. Our program-wide aim is: to characterize the impact of stress-related sleep disruptions on health in older adults, including AD caregivers, recent widows/widowers, patients with insomnia in primary care settings, and healthy elders above the age of 75 years. The main hypotheses to be tested within the individual project are that the stress of caregiving has a detrimental effect on sleep and that stress-related sleep disruptions, in turn, negatively impact health and well-being. It is hypothesized that, relative to the attention-only control condition, the active intervention (SM+HSP) will result in improvements in sleep and subsequent improvements in health and well-being.