Mindfulness Meditation and Insomnia in Alzheimer Disease Caregivers (CARES)
30. september 2022 opdateret af: Michael Irwin, MD, University of California, Los Angeles
Mindfulness Meditation and Insomnia in Alzheimer Disease Caregivers: Inflammatory and Biological Aging Mechanisms
Treatment of insomnia in caregivers is needed given that 60% of Alzheimer disease caregivers report sleep complaints, and insomnia may add to the burden of AD caregiving and contribute to morbidity and mortality risk.
This is the first intervention trial in AD caregivers to target insomnia and also evaluate two mechanisms of chronic disease risk, inflammation and cellular aging
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
This randomized controlled trial aims to evaluate the non-inferiority of Mindful Awareness Practices for Insomnia (MAP-I ) vs. Cognitive Behavioral Therapy for Insomnia (CBT-I) on outcomes of insomnia, cellular and genomic markers of inflammation, and cellular aging in older adult AD spousal caregivers with insomnia (N=150) over one-year follow-up. The specific aims of this project are:
Primary Aim 1: Determine the effects of MAP-I vs. CBT-I on subjective and objective dimensions of insomnia.
Secondary Aim 1: Evaluate the effects of MAP-I vs. CBT-I on cellular and genomic markers of inflammation.
Secondary Aim 2: Evaluate the effects of MAP-I vs. CBT-I on markers of cellular aging.
Exploratory Aim 1: Explore moderating effects of caregiver stress (Stress and Adversity Inventory, STRAIN, number & experienced intensity of stress exposure) on insomnia outcomes, and effects of MAP-I vs. CBT-I on caregiver stress, health functioning, chronic medical morbidity and related medication use at follow-up.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
139
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
California
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Los Angeles, California, Forenede Stater, 90095
- Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
45 år til 95 år (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Alzheimer or other dementia caregivers
- Older than 45 years of age
- Self-identified as the principal person taking care of the patient with Alzheimer or other dementia
- Diagnostic and Statistical Manual Criteria - 5 for Insomnia
Exclusion Criteria:
- Psychiatric disorders including current major depressive disorder or other current DSM-5 psychiatric disorder (e.g. substance dependence) with the exception of anxiety disorder;
- Psychotic symptoms;
- Acute suicidal or violent behavior or history of suicide attempt within the last year
- Other sleep disorders including current or lifetime history of sleep apnea, nocturnal myoclonus, phase-shift disorder as identified by SCID-5 and Duke Structured Interview for Sleep Disorders (DSISD)
- Medical conditions such as acute or uncontrolled medical illness (e.g., major surgery, metastatic cancer, Class III heart failure, inflammatory disorder)
- Chronic infections
- Obesity with body mass index (BMI) >35
- Use of hormone containing medications including steroids or immune modifying drugs
- Daily use of analgesics such as opioids;
- Daily us of sedative hypnotic medications
- Cognitive impairment as evidenced by DSM-5 interview and/or Mini-Mental Status Exam (MMSE < 26)
- Actively practicing a mind body intervention.
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Aktiv komparator: CBT-I
Cognitive behavioral therapy for insomnia (CBT-I), considered the treatment of choice by the American Academy of Sleep Medicine, combines cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation to improve sleep outcomes, with demonstrated efficacy in adult and older adult populations
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CBT-I is a behavioral treatment for insomnia
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Eksperimentel: MAP-I
The Mindful Awareness Practices (MAPs) is a validated and curriculum-based meditation similar to Mindfulness Based Stress Reduction, with the exception that MAPs does not include a day-long retreat or yoga and hence takes a more practical and accessible approach that focuses specifically on the practice of mindfulness and its application in everyday life.
(http://marc.ucla.edu)
MAP for Insomnia (MAP-I) is a modified version of MAPs that incorporates practice prior to bed, use of practice in the bed during night-time awakenings, and daily body scan.
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MAP-I is a mindfulness meditation treatment for insomnia
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Insomnia clinical response
Tidsramme: One-year
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Change in severity of insomnia as measured by the Insomnia Severity Index
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One-year
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Insomnia clinical response
Tidsramme: One year
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Change in severity of insomnia as measured by clinical diagnosis
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One year
|
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Daytime dysfunction
Tidsramme: One year
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Change in depressed mood as measured by the Inventory of Depressive Symptoms
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One year
|
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Inflammation
Tidsramme: One year
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Change in markers of systemic inflammation as measured by C-reactive protein
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One year
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Cellular aging
Tidsramme: One year
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Change in markers of cellular aging as measured by transcriptional profiles of the senescent secretory associated phenotype (SASP)
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One year
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Ledende efterforsker: Michael R Irwin, M.D., University of California, Los Angeles
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
1. juli 2018
Primær færdiggørelse (Faktiske)
1. september 2022
Studieafslutning (Faktiske)
30. september 2022
Datoer for studieregistrering
Først indsendt
16. maj 2018
Først indsendt, der opfyldte QC-kriterier
16. maj 2018
Først opslået (Faktiske)
29. maj 2018
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
4. oktober 2022
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
30. september 2022
Sidst verificeret
1. juni 2021
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 16-001256
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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