Sleep Learning Education and Empowerment for Older Korean Immigrants (SLEEP-OK)

A Culturally Adapted Sleep Intervention Program for Older Asian Immigrants With Limited English Proficiency

Poor sleep is common among Asian Americans. Untreated sleep problems increase the risk of chronic diseases, cognitive decline, and mortality. Cognitive behavioral therapy for insomnia (CBTI) is considered the first-line treatment for chronic sleep problems and has demonstrated significant improvement in sleep health among older adults. However, existing CBTI is built upon Western culture, making it challenging to apply for Asian immigrants who maintain close ties to their native cultures that shape and influence their sleep habits. Addressing the lack of availability of a culturally adapted sleep intervention program is the first step to filling the gap in sleep health disparity among Asian immigrants.

This study aims to pilot test the feasibility and the preliminary efficacy of a culturally adapted sleep intervention program among older Korean immigrants with poor sleep, one of the fastest-growing immigrant groups in the United States with limited access to mainstream sleep therapies.

Study Overview

• Status: Recruiting
• Conditions: Insomnia Chronic
• Intervention / Treatment: Behavioral: CBT-I based sleep intervention; Behavioral: Sleep Education

Detailed Description

Poor sleep is common among Asian Americans. Untreated sleep problems increase the risk of chronic diseases, cognitive decline, and mortality. Addressing the lack of availability of a culturally adapted sleep intervention program is the first step to filling the gap in sleep health disparity among Asian immigrants. This study aims to evaluate its feasibility and preliminary efficacy of a culturally adapted sleep education program ("SLEEP-OK") in a pilot randomized clinical trial. Study participant (N=32) will be randomized to either our culturally adapted, manual-based sleep intervention group (n=16) or the information-only control group (n=16) at our community partner serving older Korean immigrants. The study will evaluate the feasibility of the intervention and the preliminary effects of the intervention on sleep health outcomes among Korean immigrants at baseline and post-intervention (i.e., immediately after the last session of the intervention).

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yeonsu Song, PhD; Phone Number: 310-983-3029; Email: ysong@sonnet.ucla.edu

Study Locations

• United States
  • California
    • Los Angeles, California, United States, 90095
      • Recruiting
      • University of California Los Angeles
      • Contact: Yeonsu Song, PhD; Phone Number: 310-983-3029; Email: ysong@sonnet.ucla.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Korean immigrants (i.e., being a resident of the United States with a birthplace in Korea)
• Able to speak, read, and write in Korean
• Aged at least 60 years
• Have a score of at least 15 on a Korean version of the Insomnia Severity Index
• Able to ambulate with or without an assistive device
• Have a score of at least 23 on a Korean version of the Montreal Cognitive Assessment (MoCA)
• Score less than 5 on STOP-BANG (or proceed with an additional testing [Watch Peripheral Arterial Tonometry (WatchPAT) and the Epworth Sleepiness Scale if score is equal to or greater than 5 on STOP-BANG)

Exclusion Criteria:

• Those who are bedbound
• Those who do not meet the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for insomnia disorder
• Those who have an untreated apnea-hypopnea index (AHI) at least 15 (moderate obstructive sleep apnea) and Epworth Sleepiness Scale (ESS) at least 11 (indicating mild sleepiness) OR AHI is equal to or greater than 30 (irrespective of ESS)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Sleep Intervention Program; This is a culturally adapted sleep education program built upon key components of cognitive behavioral therapy for insomnia (CBT-I)	Behavioral: CBT-I based sleep intervention; A multicomponent behavioral sleep program, consisting of sleep compression, stimulus control, sleep hygiene, relaxation, daily physical activity, and light exposure
Placebo Comparator: Control; This involves with general information about sleep	Behavioral: Sleep Education; This group will receive information about sleep and aging, but without specific or individualized recommendations

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective Sleep Efficiency	Nighttime sleep efficiency (i.e., mean percent of time in bed spent asleep at nighttime) will be calculated from 7 consecutive days and nights of wrist actigraphy (Scores range from 0 to 100%, with higher values indicating better objective sleep quality)	Immediately after the last session of the intervention
Subjective Sleep Quality	Total score on the Korean version of the Insomnia Severity Index (ISI) will be used as a measure of subjective sleep (Scores range from o to 18, with lower values indicating better subjective sleep quality)	Immediately after the last session of the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of the Intervention	Focus group interviews will be conducted to collect the benefits and challenges of following the sleep intervention program	Immediately after the last session of the intervention

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of Recruitment	The number of participants approached who agreed to participate will be measured	Immediately after enrolled
Feasibility of Randomization and Retention	The number of participants lost at a post-treatment assessment will be measured	Immediately after enrolled
Adherence to the Intervention	The total number of sessions and the percentage of days that participants met goals for recommendations throughout the intervention program will be measured	Immediately after the last session of the intervention
Interventionist Adherence	The percentage of completion of delivery of each component in sessions throughout the intervention program will be measured	Immediately after the last session of the intervention

Collaborators and Investigators

• Sponsor: University of California, Los Angeles
• Collaborators: National Institute on Aging (NIA)

Study record dates

Study Major Dates

• Study Start (Actual): February 24, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): January 4, 2027

Study Registration Dates

• First Submitted: January 27, 2026
• First Submitted That Met QC Criteria: January 27, 2026
• First Posted (Actual): February 4, 2026

Study Record Updates

• Last Update Posted (Actual): March 5, 2026
• Last Update Submitted That Met QC Criteria: March 3, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: sleep; older Korean Americans; behavioral approach
• Additional Relevant MeSH Terms: Nervous System Diseases; Mental Disorders; Sleep Wake Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Initiation and Maintenance Disorders
• Other Study ID Numbers: R21AG086817 (U.S. NIH Grant/Contract); 1R21AG086817-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: IPD difficulty masking the identity of participants will not be shared publicly. However, all de-identified data and metadata will be made available through National Sleep Research Resource (NSRR), an NHLBI-funded resource at the time of the associated publication or the end of this project year, whichever comes first. Final research data and metadata will be shared by the end of the project period or at the time of publication, whichever is sooner, and will remain accessible indefinitely.
• IPD Sharing Time Frame: by the end of the project period or at the time of publication, whichever is sooner,
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No