Tuning environmental lighting improves objective and subjective sleep quality in older adults

BACKGROUND As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. OBJECTIVE The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. METHODS During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. RESULTS Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, P<.001) and memory complaints (40/40; ρ=.46, P=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; t8=3.74, P=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. CONCLUSIONS This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.

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The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

10.2196/preprints.35964 ◽

2021 ◽

Author(s):

Yvonne Kutzer ◽

Lisa Whitehead ◽

Eimear Quigley ◽

Shih Ching Fu ◽

Mandy Stanley

Keyword(s):

Older Adults ◽

Cognitive Behavioral Therapy ◽

Sleep Quality ◽

Mixed Model ◽

Linear Mixed Model ◽

Behavioral Therapy ◽

Sleep Onset ◽

Poor Sleep ◽

Subjective Sleep Quality ◽

Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

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Effects of Moderate-Intensity Exercise on Polysomnographic and Subjective Sleep Quality in Older Adults With Mild to Moderate Sleep Complaints

The Journals of Gerontology Series A ◽

10.1093/gerona/63.9.997 ◽

2008 ◽

Vol 63 (9) ◽

pp. 997-1004 ◽

Cited By ~ 118

Author(s):

A. C. King ◽

L. A. Pruitt ◽

S. Woo ◽

C. M. Castro ◽

D. K. Ahn ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Moderate Intensity ◽

Moderate Intensity Exercise ◽

Subjective Sleep Quality ◽

Sleep Complaints ◽

Subjective Sleep

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Mobile App Use for Insomnia Self-Management in Urban Community-Dwelling Older Korean Adults: Retrospective Intervention Study

JMIR mhealth and uhealth ◽

10.2196/17755 ◽

2020 ◽

Vol 8 (8) ◽

pp. e17755

Author(s):

Kyungmi Chung ◽

Seoyoung Kim ◽

Eun Lee ◽

Jin Young Park

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Problems ◽

Mobile App ◽

Community Dwelling ◽

Intervention Period ◽

Post Intervention ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Self Help

Background As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. Objective The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. Methods During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. Results Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, P<.001) and memory complaints (40/40; ρ=.46, P=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; t8=3.74, P=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. Conclusions This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.

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SUBJECTIVE SLEEP QUALITY AMONG SARCOPENIC AND NON-SARCOPENIC OLDER ADULTS: RESULTS FROM THE SARCOPHAGE COHORT

Journal of Frailty & Aging ◽

10.14283/jfa.2018.13 ◽

2018 ◽

pp. 1-6

Author(s):

M. LOCQUET ◽

C. BEAUDART ◽

L. DELANDSHEERE ◽

J.-Y. REGINSTER ◽

O. BRUYÈRE

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Community Dwelling ◽

Subjective Sleep Quality ◽

Cross Sectional ◽

Subjective Sleep ◽

Significant Difference ◽

Age Cohort ◽

Definition Of ◽

A Prospective Study

Background: It seems that sleep quality could impact the physiological process related to loss of muscle mass. Objectives: We seek to compare subjective sleep quality of sarcopenic and non-sarcopenic subjects diagnosed according to 6 definitions. Design: Cross-sectional data used in this analysis were collected from the SarcoPhAge (Sarcopenia & Physical Impairment with Advancing Age) cohort, a prospective study aiming to assess clinical parameters linked to sarcopenia. Participants: The present study was interested in community-dwelling older adults with and without sarcopenia. Measurements – A diagnosis of sarcopenia was established according to 6 definitions. Three assessments were carried out: an evaluation of lean mass, a measurement of muscle strength and an assessment of physical performance. In addition, to evaluate the parameters of subjective sleep, we used the Pittsburgh Sleep Quality Index (PSQI), a self-administered questionnaire evaluating 7 components of sleep architecture. Results: A total of 255 individuals aged 74.7±5.8 years were included. Based on the 6 different definitions, the prevalence of sarcopenia ranged from 5.9% to 32.5%. There was no significant difference between sarcopenic and non-sarcopenic subjects regarding most of the components of subjective sleep quality. However, the definition of Cruz-Jentoft et al. (2010) indicated that sarcopenic subjects had higher scores than non-sarcopenic subjects for two components: sleep latency and day-time dysfunction (p=0.03 and p=0.04, adjusted for confounders). Moreover, some parameters of sleep quality were correlated with components of sarcopenia. Conclusions: Some properties of subjective sleep quality seem to be associated with sarcopenia and seem correlated with at least one of the three components of the condition.

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Subjective sleep quality in non-demented older adults with and without cognitive impairment

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4087 ◽

2014 ◽

Vol 29 (9) ◽

pp. 970-977 ◽

Cited By ~ 5

Author(s):

Anne-Marie Adam ◽

Olivier Potvin ◽

Brandy L. Callahan ◽

Célyne Bastien ◽

Dominique Lorrain ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Sleep Quality ◽

Subjective Sleep Quality ◽

Subjective Sleep

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773 The relationship between personality and sleep: Subjective cognition as a mediator

SLEEP ◽

10.1093/sleep/zsab072.770 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A301-A301

Author(s):

Anthony Schmiedeler ◽

Maggie Connell ◽

Ashley Curtis

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Personality Traits ◽

Middle Aged ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Everyday Cognition ◽

Individual Personality ◽

Cognitive Failures ◽

The Relationship

Abstract Introduction Research has found relationships between sleep quality and personality traits. Poor subjective sleep quality has been observed within individuals scoring high in Neuroticism and low in Conscientiousness. Personality traits have also been associated with cognitive functioning and the link being worse cognition and poor sleep quality is established. However, less is known regarding the role of cognitive functioning in the relationship between personality and sleep quality, particularly in aging populations. This study investigated whether subjective cognition acted as a mediator between individual personality traits and subjective sleep quality in middle-aged and older adults. Methods Middle-aged and older adults (N=269; Mage= 64.5, SD=7.8; 123 women/146 men) who were cognitively healthy completed an online survey through Qualtrics measuring demographics, personality (Big Five Inventory-10; BFI-10), self-reported sleep (Pittsburgh Sleep Quality Index; PSQI), and subjective everyday cognition (Cognitive Failures Questionnaire; CFQ). Separate mediation analyses using SPSS PROCESS macro [and testing for indirect effects using 5,000 bootstrapped samples and 95% Confidence Interval (CI) and controlling for conditional associations among all pathways] examined whether subjective everyday cognition (CFQ scores) mediated the relationship between different personality traits (BFI-10 Conscientiousness and Neuroticism scores) and self-reported sleep (PSQI-Total Score), controlling for age and sex. Results Neuroticism and PSQI-Total Score was partially mediated by CFQ. There was a significant association between Neuroticism and total PSQI (total effect=0.588, SE=0.110, p<0.001). There were positive associations between Neuroticism and CFQ (a-path effect=2.765, SE=0.383, p<0.001) and CFQ and PSQI (b-path effect=0.068, SE=0.017, p<0.001). The indirect effect was significant (effect=0.187, SE=0.054, 95% CI=0.088 to 0.301). There was no association between Conscientiousness and PSQI-Total Score (total effect=-0.123, SE=0.133, p=0.358), therefore mediation analysis (testing of CFQ as a mediator) was discontinued. Conclusion In middle-aged and older adults, subjective everyday cognition mediates the relationship between Neuroticism personality trait and self-reported sleep quality. Individuals scoring higher in Neuroticism report worse subjective sleep quality as their subjective cognitive failures increase. Findings underscore the interacting roles of personality and everyday cognition on perceived sleep. Clinicians should consider individual personality profiles (via personality assessments) and subjective everyday cognitive ratings for a better understanding of the factors impacting middle-aged and older adults’ sleep profiles. Support (if any):

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Psychological Pathways Linking Parent-Child Relationships to Subjective and Objective Sleep Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1926 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 579-579

Author(s):

Haowei Wang ◽

Kyungmin Kim ◽

Jeffrey Burr ◽

Bei Wu

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Sleep Quality ◽

Social Life ◽

Structural Equation ◽

Equation Modeling ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Parent Child Relationships ◽

Parent Child

Abstract This study investigated whether older adults’ relationships with their children were associated with their self-reported subjective sleep quality and actigraphy-measured objective sleep characteristics, as well as whether depressive symptoms and loneliness mediated the association between these parent-child relationships and sleep. Data were taken from the second wave of the National Social life, Health, and Aging Project, in which 569 respondents (age 57-85) participated in the sleep module, along with the social network module that provided relationship information for participants and their children. Results from structural equation modeling showed that (1) parents’ closeness with children was associated with better objective sleep (i.e., fragmentation of sleep and percent sleep), (2) more frequent contact with children was related to better subjective sleep quality, (3) depressive symptoms and loneliness were associated with worse subjective sleep quality, and (4) less closeness with children were related to worse subjective sleep quality via older adults’ depressive symptoms. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.

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