Preliminary feasibility of technology use in an internet‐delivered intervention: Improving sleep in older adults with mild cognitive impairment

• Published in: Alzheimer's & dementia Vol. 16
• Main Authors: Mattos, Meghan K, Barnes, Laura, Davis, Eric M, Manning, Carol A, Mostafavi, Moeen, Quigg, Mark S, Perez, Hillary, Sollinger, Ann, Ritterband, Lee M
• Format: Journal Article
• Language: English
• Published: 01.12.2020
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.038831

Background Individuals with mild cognitive impairment (MCI) experience more sleep disturbances than individuals without MCI, and improving sleep in this at‐risk group may delay progression to Alzheimer’s disease. Internet‐based interventions may promote access to treatments for sleep disorders, such as insomnia. However, preliminary studies examining technology use and compliance are needed prior to undertaking large‐scale interventions in this population. Method Older adults (≥55 years old) with MCI are recruited from hospital‐based memory and sleep disorders clinics and enrolled in a single‐arm intervention pilot study. An existing Internet‐delivered cognitive behavioral therapy for insomnia (CBT‐I)called Sleep Healthy Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness (SHUTi OASIS) collects daily sleep diary data and delivers the automated intervention over nine weeks. Wrist‐worn actigraphs are used to collect subject objective sleep data over two 14‐day periods, pre‐ and post‐intervention. SHUTi OASIS sends daily morning emails to remind subjects to complete the sleep diary and wear the actiwatch at night. There are only two in‐person study visits over the 4‐5 month study duration. Care partners are invited to enroll in the study to share their experience observing or assisting their loved one. Descriptive statistics for technology use are presented for the baseline study period. Result Seven subjects are enrolled in the ongoing study and are, on average, 76.0±5.4 years of age, mostly female (4/7), with an average MoCA of 22.7±3.1 (19‐28).Four care partners, all spouses, are enrolled. All subjects with MCI completed 10 sleep diaries over 14 days, most accessing the SHUTi OASIS program daily. Actiwatch data show that subjects wore the actiwatch between 5‐14 days. Conclusion Consistent daily or every other day sleep diary entry may be in response to viewing the automated e‐mail reminders and immediately logging into SHUTi OASIS to complete their daily entry. Although subjects were accepting of wrist‐worn actigraphy, there was inconsistent wear time at night, which may be related to the early‐morning timing of e‐mail reminders. Incorporating technology for subjective and objective sleep data collection in this population is promising, and future work should consider frequency and timing of reminders with multimodal technology use.