Accepted for/Published in: JMIR Research Protocols
Date Submitted: Aug 6, 2021
Date Accepted: Nov 18, 2022
The Role of Dysfunctional Sleep Beliefs in Mediating the Outcomes of Online Cognitive Behavioral Therapy for Insomnia in Community-dwelling Older Adults: Protocol for a Single-Group Non-randomized Trial
ABSTRACT
Background:
Sleeping well is an essential part of good health. Older adult populations report a high rate of sleep problems, with recent studies suggesting that cognitive processes such as sleep state misperception (objective good sleep but perceived poor sleep and vice versa) and dysfunctional sleep cognitions could be contributing factors to the development and maintenance of insomnia.
Objective:
This study aims to assess objective and subjective sleep quality in community-dwelling older adults aged 60-80 years residing in Western Australia and will examine the role of cognitive processes, such as dysfunctional sleep beliefs, in mediating treatment outcomes of an online Cognitive Behavioral Therapy program for insomnia.
Methods:
The study will be completed in two phases: Phase 1 will assess sleep quality with a specific focus on examining both objective sleep (measured via wrist actigraphy) and subjective (self-reported) sleep quality. Phase 2 will investigate the impact of an online Cognitive Behavioral Therapy program for insomnia on the sleep outcomes of individuals with sleep state misperception compared with those without. Additional factors that may mediate the relationship between online CBT-I and sleep outcomes in older adults, such as dysfunctional sleep beliefs, will also be examined. Multivariate analyses of variance will be conducted to examine subjective sleep quantity by gender for complaining and non-complaining sleepers. Multivariate analyses of variance (MANOVA) will be utilized to examine subjective and objective sleep quality and dysfunctional sleep beliefs for complaining and non-complaining sleepers. In addition, partial mediation analysis will be conducted to assess whether improvements in sleep quality in older adults following online CBT-I are the result of changes in sleep-related beliefs.
Results:
Study recruitment was completed in March 2021. The first results of this study are expected to be submitted for publication in late 2021.
Conclusions:
It is crucial to examine the role of dysfunctional beliefs and perceptions in older adults as previous research as has suggested that insomnia is particularly prevalent in this age group. Should cognitive processes such as dysfunctional beliefs and sleep state misperception be implicated in this process, this could provide valuable avenues of treatment for older adults and strengthen the argument for the provision of CBT-I as the gold standard of treatment. Clinical Trial: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451
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