0384 Multicomponent Behavioral Sleep Intervention for Insomnia in Older Adults with Mild Cognitive Impairment

Abstract Introduction Insomnia is prevalent in older adults with mild cognitive impairment. Current treatment options are limited due to the nature of cognitive impairment and a paucity of providers. We sought to determine the preliminary effects of a multicomponent behavioral sleep intervention (MBSI) compared to a sleep education control condition on sleep latency, wake after sleep onset, total sleep time and efficiency. Methods Participants were enrolled and randomized in a 1:1 ratio to intervention or control in this pilot randomized controlled trial. Inclusion criteria were: self-reported and diary based evidence of insomnia (latency ≥ 30 minutes or wake after sleep onset ≥ 60 minutes) and Modified Telephone Interview for Cognitive Status scores between 28-36. The intervention was delivered virtually via tablet and consisted of sleep hygiene education, meaningful activity in the daytime and relaxation therapy in the evening for 4 weeks. The active control received sleep hygiene education only. Data collection occurred at baseline and immediately post intervention. Sleep variables were averaged over one week at each time point from daily sleep diaries. We used non-parametric Kruskal-Wallis tests to compare intervention and control post-intervention. Results We screened 180 potential participants and enrolled 27 older adults with mild cognitive impairment. Our sample was balanced on all key variables, had a mean age of 65.63 ± 6.39, was primarily (81.5%) female, and mixed between white (51.9%), Black (44.4%). Retention rate was high at almost 90%. At baseline, average latency was 46.5 (27.3) minutes for control and 41.4 (33.10) for intervention group. Post intervention, average latency for control group was 47.0 (34.6) and 28.3 (31.8) for intervention (p=0.076) Standardized mean difference (SMD) was 0.56. Average efficiency for control group was 65% (11%) and 70% (12%) for intervention at baseline. Post intervention, efficiency was 68% (14%) for control group and 78% (12%) for intervention (p=0.044). SMD was 0.76. There were no significant differences between groups for wake after sleep onset or total sleep time. Conclusion Preliminary evidence supports testing MBSI on a larger scale to improve insomnia symptoms in older adults with mild cognitive impairment and to determine if these effects are sustained over time. Support (if any) K23NR018487