Intraindividual Variability in Sleep and Cognitive Performance in Older Adults (REST)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age >65 years
- Community dwelling
- Available for duration of study
- Insomnia according to American Sleep Disorders Association (1990) criteria: (a) >30 minutes of unwanted awake time, 3 nights per week for at least 6 months and (b) Daytime dysfunction (reported mood, cognitive, social, or occupational impairment)
Exclusion Criteria:
- Age less than 65
- history of primary sleep disorder (e.g., sleep apnea, narcolepsy)
- history of stroke
- major medical illness known to contribute to sleep problems in last 12 months
- cognitive impairment that interferes with ability to understand treatment (score <23 on Mini-Mental State Examination)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Brief Behavioral Therapy for Insomnia
Treatment will consist of 4 weekly, 1 hour sessions and will be conducted by a trained graduate assistant on an individual basis.
|
Treatment will consist of 4 weekly, 1 hour sessions and will be conducted by a trained graduate assistant on an individual basis.
Treatment components will include education about aging and sleep.
It will also include instruction in techniques designed to: (a) promote good sleep habits, (b) restrict the use of the bed and bedroom to sleep and sleep-conducive activities, (c) modify bed and wake times to better match the participants sleep needs, and (d) promote relaxation.
Daily home practice of these techniques will be encouraged.
Participants will maintain logs of their home practice sessions and will continue to record their daily sleep habits throughout treatment.
|
|
No Intervention: Waitlist Control
Participants in this group will receive no intervention, but will complete the same set of assessments as those in the Experimental Group.
They will be given the option of receiving the behavioral treatment program at no charge.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in diary-assessed total sleep and wake time during sleep from baseline to follow-up
Time Frame: from baseline to follow-up, approximately 1 year
|
Participants will complete a daily sleep dairies throughout the study period.
They will report their bedtime, waketime, sleep onset latency, and wake time after sleep onset.
Total sleep time and total wake time will be calculated from the diaries.
|
from baseline to follow-up, approximately 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in actigraphy-assessed sleep variability from baseline to follow-up
Time Frame: from baseline to follow-up, approximately 1 year
|
Participants wore an Actiwatch-L (ACTL) (Mini Mitter Co., Inc.) on their non-dominant wrists continuously throughout the study.
The sensor of the ACTL is sampled 32 times per second and records peak values for each second.
These peak values are then summed into 30-second "activity" counts.
These activity counts are downloaded to a personal computer and analyzed using Actiware-Sleep v. 3.3, which uses a validated algorithm to identify periods of as sleep or wake.
Total sleep time and total wake time will be computed.
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the Mini-Mental Status Exam
Time Frame: from baseline to follow-up, approximately 1 year
|
Mini-Mental Status Exam (MMSE) (Folstein, Folstein, & McHugh, 1975)
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on Wechsler Adult Intelligence Scale-3, Vocabulary & Digit Symbol
Time Frame: from baseline to follow-up, approximately 1 year
|
Wechsler Adult Intelligence Scale-3, Vocabulary & Digit Symbol (subtests) [WAIS-3]
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the Trails A & B (Reitan, 1958)
Time Frame: from baseline to follow-up, approximately 1 year
|
Trails A & B (Reitan, 1958) was administered
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the Controlled Oral Word Association
Time Frame: from baseline to follow-up, approximately 1 year
|
Controlled Oral Word Association (COWA) (Benton & Hamsher, 1983)
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the Boston Naming Test (BNT)
Time Frame: from baseline to follow-up, approximately 1 year
|
Boston Naming Test (BNT)
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the California Verbal Learning Test (CVLT, CVLT-II)
Time Frame: from baseline to follow-up, approximately 1 year
|
California Verbal Learning Test (CVLT, CVLT-II) (Delis, Kramer, Kaplan, & Ober, 1987)
|
from baseline to follow-up, approximately 1 year
|
|
Change in performance on the Rey-Osterreith Complex Figure Test (Rey-O) (Hubley & Tremblay, 2002)
Time Frame: from baseline to follow-up, approximately 1 year
|
from baseline to follow-up, approximately 1 year
|
|
|
Change in performance on the Wechsler Memory Scale-3, Logical Memory & Visual Reproduction subtests (WMS-3) Tremblay, 2002)
Time Frame: from baseline to follow-up, approximately 1 year
|
from baseline to follow-up, approximately 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Christina McCrae, PhD, University of Missouri-Columbia
Publications and helpful links
General Publications
- McCrae CS, McGovern R, Lukefahr R, Stripling AM. Research Evaluating Brief Behavioral Sleep Treatments for Rural Elderly (RESTORE): a preliminary examination of effectiveness. Am J Geriatr Psychiatry. 2007 Nov;15(11):979-82. doi: 10.1097/JGP.0b013e31813547e6.
- McCrae CS, Curtis AF, Williams JM, Dautovich ND, McNamara JPH, Stripling A, Dzierzewski JM, Berry RB, McCoy KM, Marsiske M. Effects of Brief Behavioral Treatment for Insomnia on Daily Associations between Self-Reported Sleep and Objective Cognitive Performance in Older Adults. Behav Sleep Med. 2020 Sep-Oct;18(5):577-588. doi: 10.1080/15402002.2019.1632201. Epub 2019 Jun 15.
- Curtis AF, Williams JM, McCoy KJM, McCrae CS. Chronic Pain, Sleep, and Cognition in Older Adults With Insomnia: A Daily Multilevel Analysis. J Clin Sleep Med. 2018 Oct 15;14(10):1765-1772. doi: 10.5664/jcsm.7392.
- McCrae CS, Curtis AF, Williams JM, Dautovich ND, McNamara JPH, Stripling A, Dzierzewski JM, Chan WS, Berry RB, McCoy KJM, Marsiske M. Efficacy of brief behavioral treatment for insomnia in older adults: examination of sleep, mood, and cognitive outcomes. Sleep Med. 2018 Nov;51:153-166. doi: 10.1016/j.sleep.2018.05.018. Epub 2018 Jun 2.
- Chan WS, Williams J, Dautovich ND, McNamara JPH, Stripling A, Dzierzewski JM, Berry RB, McCoy KJM, McCrae CS. Night-to-Night Sleep Variability in Older Adults With Chronic Insomnia: Mediators and Moderators in a Randomized Controlled Trial of Brief Behavioral Therapy (BBT-I). J Clin Sleep Med. 2017 Nov 15;13(11):1243-1254. doi: 10.5664/jcsm.6790.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 221286
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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