Sleep Interventions and Neurocognitive Outcomes

Launched by NEW YORK STATE PSYCHIATRIC INSTITUTE · Aug 3, 2023

Keywords

ClinConnect Summary

This clinical trial, titled "Sleep Interventions and Neurocognitive Outcomes," is designed to explore how different sleep treatments can improve sleep quality and brain function in older adults aged 60 to 85 who have mild cognitive impairment and sleep disturbances. The study will compare two types of interventions: cognitive behavioral therapy for insomnia (CBTI) and a method called acoustic slow-wave activity enhancement (SWAE). Over a 6-month period, participants will be evaluated to see how these treatments affect their memory and daily functioning.

To be eligible for this study, participants need to speak English and have a specific score on a memory test indicating mild cognitive impairment. They should also experience sleep disturbances but cannot be using sleep medications frequently. Participants will need a stable internet connection and someone, like a family member, to help provide information during the study. It's important to know that the trial is not yet recruiting participants, but it aims to help improve sleep and cognitive health in older adults.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. English speaking participants, ages 60-85 years
• • 2. Telephone MMSE (T-MMSE) score of 22 or greater at screening assessment; T-MMSE \<18 during post-treatment visit or 6-month follow-up will be discontinued from participation of the study.
• • 3. Individuals with aMCI, as determined by the Wechsler Memory Scale-Revised Logical Memory Delayed Recall (LM) and Quick Dementia Rating Scale (QDRS)
• • 4. Presence of subject memory complains not exclusionary. Presence of subjective memory complaints without objective signs of impairment (T-MMSE, QDRS, LM) would not be considered as the presence of late MCI or dementia, therefore are not exclusionary.
• • 5. Participants with regular and consistent use of sleep medications (sedatives/hypnotic use of \>3 times per week) will be excluded. Participants who take sleep medications 3 or less times per week will be asked to discontinue medications prior to the study baseline visit. All discontinuation/tapering procedures will require PI's direct consultation with participants' prescribing or primary care physicians, which will be documented to ensure participants' safety.
• • 6. Presence of sleep disturbance, as determined by score of 8 or greater on the Insomnia Severity Index administered at baseline (without sleep medications).
• • 7. Participants must have capacity to provide informed consent.
• • 8. Have access to stable internet connection.
• • 9. A family member or other individual who is in contact with the subject and consents to serve as informant during the study; this can be a telephone informant in the case of subjects who do not have a live-in informant
• Exclusion Criteria:
• • 1. Diagnosis of stroke or excessive risk of CVD
• • 2. Neurologic disease including movement disorders, MS, epilepsy, and TBI (with greater than 15 min loc)
• • 3. Untreated diabetes
• • 4. Active treatment of cancer
• • 5. Telephone MMSE score below 22 (Newkirk et al., 2004) and Logical Memory above 11 for subjects with 16 or more years of education, 9 for subjects with 8-15 years of education, and 6 for subjects with 0-7 years of education
• • 6. Presence of sleep disorders other than insomnia (moderate-severe sleep apnea, REM-behavior disorder, restless legs syndrome, circadian rhythm disorder). Mild sleep apnea will not be exclusionary.
• • 7. Current DSM-5 Axis I psychiatric diagnosis of schizophrenia, schizoaffective disorder, substance/alcohol use disorder, or bipolar disorder
• • 8. Use of antidepressants with known large anticholinergic properties will be excluded. These include: amitriptyline, amoxapine, clomipramine, desipramine, doxepine, imipramine, isocarboxazide, lithium, maprotiline, mirtazapine, nortriptyline, tranylcypromine trimipramine, and phenelzine. Other medications are allowed during the study and are not exclusionary.
• • 9. Participants taking medications with benzodiazepines properties will be excluded. These include: diazepam, quazepam, estazolam, alprazolam, clorazepate, clorazepate, oxazepam, alprazolam, chlordiazepoxide, lorazepam, flurazepam, triazolam, temazepam, and midazolam.
• • 10. Participants with moderate to severe depression (Geriatric Depression Scale\>8) will be excluded from the study and will be encouraged to seek treatment for their symptoms. Participants with moderate depression (GDS 5-8) will be encouraged to return for screening after receiving treatment and seeing improvement in their symptoms.
• • 11. Participants who are unable to provide an informant.