A Dyadic Approach to Improve Sleep and Well-Being Among Persons with Alzheimer's Disease and Their Caregivers

项目总结/摘要 睡眠不佳在阿尔茨海默病和相关痴呆症（ADRD）患者中非常常见， 他们的照顾者。它与不良的精神和身体健康结果和幸福感显著相关 在这两个群体的成员。不受管理的睡眠不足将进一步影响护理人员的护理质量， 为病人提供。这表明在这个脆弱的人群中迫切需要睡眠管理。 不幸的是，同时解决两个成员的睡眠问题的干预措施是 缺乏，特别是使用在其他群体中有效的行为策略。睡眠的影响 在这一群体中，不同分娩方式的干预方案也是未知的。 目前的建议旨在检查ADRD的二元睡眠干预计划的有效性 病人和他们的照顾者，这是建立在PI的以前的工作。我们提出了一个三臂随机对照试验 设计（第二阶段），包括面对面（n=70对）和远程保健（n=70对）提供 干预，相比之下，在人的睡眠教育控制（n=70对）。双元干预是一个为期5周， 一个基于手册的程序，其中包括失眠的认知行为疗法的关键组成部分，每天 光暴露和步行，以及ADRD相关问题夜间行为的问题解决方法 和其他挑战。所有的干预课程都将由睡眠教育者提供。初级 结果包括二人组的主观和客观睡眠质量。次要结局包括 患者的痴呆相关行为和生活质量，以及照顾者的负担，抑郁和感知 健康我们还将探讨二元睡眠计划对护理人员中炎症标志物的影响。 将在基线、干预后（即，在最后一届会议之后， 干预），以及最后一次会议后6个月。上级（面对面和远程保健干预 与对照组相比）和非劣效（面对面与远程保健干预相比）。 这项工作的一个独特之处在于，该计划是为解决这两种人的睡眠问题而量身定制的。 患者和护理人员，包括炎症生物标志物，以评估干预的关键机制 这些好处可以在未来的研究中进一步探索。从这项研究中获得的知识有可能 改善ADRD患者及其护理人员的生活。我们的双元睡眠干预可以传播 为ADRD患者和/或护理人员提供服务的多个社区，包括那些无法获得 传统的面对面睡眠治疗。干预手册还可用于培训卫生专业人员 以及各类社区项目的工作人员。

Project Summary/Abstract Poor sleep is very common in persons with Alzheimer’s disease and related dementias (ADRD) and their caregivers. It is significantly associated with adverse mental and physical health outcomes and well-being in both members of the group. Unmanaged poor sleep will further impact the quality of care that the caregivers provide for the patients. This suggests a critical need of sleep management in this vulnerable population. Unfortunately, an intervention addressing sleep problems of both members of the dyad simultaneously is lacking, particularly using the behavioral strategies that have been effective in other groups. Effects of sleep intervention programs in different delivery modalities are also unknown in this group. The current proposal aims to examine the efficacy of a dyadic sleep intervention program for ADRD patients and their caregivers, that is built upon PI’s prior work. We propose a 3-arm randomized controlled trial design (Stage II), including both in-person (n=70 dyads) and telehealth (n=70 dyads) delivery of the intervention, compared to in-person sleep education control (n=70 dyads). The dyadic intervention is a 5-week, manual-based program, which incorporates key components of cognitive behavioral therapy for insomnia, daily light exposure and walking, and a problem-solving approach for ADRD-related problematic nighttime behaviors and other caregiving challenges. All intervention sessions will be delivered by a sleep educator. Primary outcomes include subjective and objective sleep quality of the dyads. Secondary outcomes include the patients’ dementia-related behaviors and quality of life, and the caregivers’ burden, depression, and perceived health. We will also explore effects of the dyadic sleep program on inflammatory markers among caregivers. All outcomes will be measured at baseline, post-intervention (i.e., immediately after the last session of the intervention), and 6-month after the last session. Both superior (both in-person and telehealth interventions versus control) and non-inferior effects (in-person versus telehealth intervention) will be tested. A unique aspect of the proposed work is that the program is tailored to address sleep problems of both patients and caregivers, and includes inflammatory biomarkers to evaluate a key mechanism of intervention benefits that can be further explored in future research. The knowledge gained from this study has the potential to improve the lives of ADRD patients and their caregivers. Our dyadic sleep intervention can be disseminated to multiple communities serving ADRD patients and/or caregivers, including those that lack access to traditional in-person sleep treatment. The intervention manual can also be used to train health professionals and staff in various types of community programs.