Digital Sleep Therapy for Older Adults With Cognitive Impairment (ExCEED)
Insomnia Type; Sleep Disorder, Cognitive Impairment
About this trial
This is an interventional treatment trial for Insomnia Type; Sleep Disorder
Eligibility Criteria
Inclusion Criteria:
- Aged 60 years and older
- Insomnia Severity Index score ≥10
- Self-reported subjective cognitive impairment as defined as moderate subjective cognitive complaints (i.e. answers YES to have cognitive concerns OR thinking and memory skills are worse than same-age peers on the online screening)
- English speaking
- Access to a smartphone and willingness/proficiency to use a mobile app for healthcare
- Able to give informed online consent
Exclusion Criteria:
- Neurological (e.g. Parkinson's, epilepsy) and major psychiatric disease (e.g. current major depression, Bipolar disorder), dementia, history of cerebrovascular events (stroke, TIA); history of head injury with loss of consciousness > 30mins
- Current illicit substance use or alcohol intake suggestive of a hazardous or harmful pattern
- Shift-work, recent transmeridian travel (within 30-days)
- Medical conditions with known effects on cognition and sleep (e.g. cancer with chemotherapy)
- Self-reported obstructive sleep apnoea, or other sleep disorder including REM Sleep Behaviour Disorder, Restless Legs Syndrome or Narcolepsy
- Currently using sleep therapies (e.g. CPAP, regular sleep medications)
Sites / Locations
- Woolcock Institute of Medical ResearchRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Treatment
Control
Participants will be instructed to use SleepFix mobile application for 3 weeks with an optional 3 weeks of additional therapy. Participants will complete daily sleep diary entries (which take less than 1 min) which are used to calculate the sleep window titration. SleepFix incorporates sleep restriction and stimulus control which have been shown to be the most powerful components of cognitive-behavioural therapy for insomnia - CBTi. It has been shown to produce rapid, clinically-meaningful insomnia symptom reduction in a shorter period of time compared with both face-to-face and digital CBTi. SleepFix does not require the user to complete modules and multiple components such as other digital CBTi programs (e.g. Sleepio). Further, it is personalised to the individual's current sleep patterns and requires minimal engagement compared to full CBTi.
Participants randomised to the control group will gain access to the first Sleep Health Education module immediately following completion of baseline questionnaires. There are 3 modules provided bi-weekly and the information in these modules is presented as a subdomain through the study website. The participant will receive a link to this information as each module is made available. Control participants will have full access to these modules for the duration of the study.