2.50
Hdl Handle:
http://hdl.handle.net/10755/158204
Type:
Presentation
Title:
Behavioral Intervention to Enhance Sleep-Wake Patterns of Older Adults
Abstract:
Behavioral Intervention to Enhance Sleep-Wake Patterns of Older Adults
Conference Sponsor:Western Institute of Nursing
Conference Year:1995
Author:Epstein, Dana
P.I. Institution Name:Tucson VAMC
Contact Address:, Tucson, AZ, USA
Contact Telephone:602.277.5551
Insomnia is a major health problem and frequent complaint of older

adults. Older persons suffer from a number of sleep difficulties

particularly an increase in the frequency of awakenings and

difficulty falling back to sleep. Insomnia in elders is often

viewed by clinicians as a normal developmental change. Apart from

prescribing medication, health care professionals often do not know

what to do about insomnia. Although prescribing practices are

beginning to change, hypnotics have been the most common treatment

of insomnia. The use of hypnotics by older individuals puts them

at risk for dangerous side effects and injury. Older adults are in

need of behavioral treatments for their sleep difficulties. Only

a small number of behavioral intervention research studies of

insomnia have targeted older adults. The present study evaluated

the effectiveness of a behavioral intervention for sleep

maintenance insomnia in elders. The specific aims of the research

addressed in this paper focused on assisting older adults with

sleep maintenance insomnia:



1. to consolidate sleep and establish a consistent sleep-wake

pattern.

2. to maintain therapeutic gains from posttreatment to the three

month follow-up assessment phase.



Twenty-two adults age 60 and older who spent 60 minutes or more

awake during the night on a minimum of three nights per week for at

least six months received treatment. The study utilized an

experimental design with repeated measures. The subjects were

randomly assigned to either an immediate or delayed (waiting list

control) treatment group. Subjects completed daily sleep diaries

and several other measures. The behavioral intervention was a

treatment package consisting of sleep restriction therapy, stimulus

control instructions, sleep education, and an optional daytime nap.

A six-week treatment program consisting of four weekly classes and

two weekly telephone interventions was implemented.



Repeated measures analysis of variances (ANOVA) of sleep behaviors

revealed an improvement in wake after sleep onset and sleep

efficiency for the immediate treatment group. After intervention,

the delayed treatment group improved on the same sleep behaviors as

well as total sleep time. The therapeutic improvement was

maintained at the three month follow-up. Favorable ratings for

therapy evaluation were received. The majority of subjects felt

they were compliant with treatment and had corresponding decreases

in wake after sleep onset. In addition to statistical

significance, the clinical significance of the study was

established.



Insomnia in older adults can be effectively treated using

nonpharmacological intervention. Nurses can significantly

contribute to alleviating the problem of insomnia. Increased

scientific knowledge regarding sleep should be made available to

nursing students at the undergraduate and graduate levels as well

as to practicing clinicians. Dissemination of existing research

findings regarding insomnia intervention with older persons can

raise the awareness of nurses who have daily contact with this

population. Nurses should consider the opportunity to participate

in the emerging multidisciplinary approach to sleep and sleep

disorders. Research in insomnia and its treatment remains

virtually an untapped area for nurse scientists.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBehavioral Intervention to Enhance Sleep-Wake Patterns of Older Adultsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158204-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Behavioral Intervention to Enhance Sleep-Wake Patterns of Older Adults</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1995</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Dana</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Tucson VAMC</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Tucson, AZ, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">602.277.5551</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dana.epstein@med.va.gov</td></tr><tr><td colspan="2" class="item-abstract">Insomnia is a major health problem and frequent complaint of older<br/><br/>adults. Older persons suffer from a number of sleep difficulties<br/><br/>particularly an increase in the frequency of awakenings and<br/><br/>difficulty falling back to sleep. Insomnia in elders is often<br/><br/>viewed by clinicians as a normal developmental change. Apart from<br/><br/>prescribing medication, health care professionals often do not know<br/><br/>what to do about insomnia. Although prescribing practices are<br/><br/>beginning to change, hypnotics have been the most common treatment<br/><br/>of insomnia. The use of hypnotics by older individuals puts them<br/><br/>at risk for dangerous side effects and injury. Older adults are in<br/><br/>need of behavioral treatments for their sleep difficulties. Only<br/><br/>a small number of behavioral intervention research studies of<br/><br/>insomnia have targeted older adults. The present study evaluated<br/><br/>the effectiveness of a behavioral intervention for sleep<br/><br/>maintenance insomnia in elders. The specific aims of the research<br/><br/>addressed in this paper focused on assisting older adults with<br/><br/>sleep maintenance insomnia:<br/><br/><br/><br/>1. to consolidate sleep and establish a consistent sleep-wake<br/><br/>pattern.<br/><br/>2. to maintain therapeutic gains from posttreatment to the three<br/><br/>month follow-up assessment phase.<br/><br/><br/><br/>Twenty-two adults age 60 and older who spent 60 minutes or more<br/><br/>awake during the night on a minimum of three nights per week for at<br/><br/>least six months received treatment. The study utilized an<br/><br/>experimental design with repeated measures. The subjects were<br/><br/>randomly assigned to either an immediate or delayed (waiting list<br/><br/>control) treatment group. Subjects completed daily sleep diaries<br/><br/>and several other measures. The behavioral intervention was a<br/><br/>treatment package consisting of sleep restriction therapy, stimulus<br/><br/>control instructions, sleep education, and an optional daytime nap.<br/><br/>A six-week treatment program consisting of four weekly classes and<br/><br/>two weekly telephone interventions was implemented.<br/><br/><br/><br/>Repeated measures analysis of variances (ANOVA) of sleep behaviors<br/><br/>revealed an improvement in wake after sleep onset and sleep<br/><br/>efficiency for the immediate treatment group. After intervention,<br/><br/>the delayed treatment group improved on the same sleep behaviors as<br/><br/>well as total sleep time. The therapeutic improvement was<br/><br/>maintained at the three month follow-up. Favorable ratings for<br/><br/>therapy evaluation were received. The majority of subjects felt<br/><br/>they were compliant with treatment and had corresponding decreases<br/><br/>in wake after sleep onset. In addition to statistical<br/><br/>significance, the clinical significance of the study was<br/><br/>established.<br/><br/><br/><br/>Insomnia in older adults can be effectively treated using<br/><br/>nonpharmacological intervention. Nurses can significantly<br/><br/>contribute to alleviating the problem of insomnia. Increased<br/><br/>scientific knowledge regarding sleep should be made available to<br/><br/>nursing students at the undergraduate and graduate levels as well<br/><br/>as to practicing clinicians. Dissemination of existing research<br/><br/>findings regarding insomnia intervention with older persons can<br/><br/>raise the awareness of nurses who have daily contact with this<br/><br/>population. Nurses should consider the opportunity to participate<br/><br/>in the emerging multidisciplinary approach to sleep and sleep<br/><br/>disorders. Research in insomnia and its treatment remains<br/><br/>virtually an untapped area for nurse scientists.</td></tr></table>en_GB
dc.date.available2011-10-26T20:36:48Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:36:48Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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