Online COgnitive Behavioural Therapy for Sleep and Mental Health for Older Adults With Insomnia and Subjective Cognitive Complaints (e-COSMOS)

Inclusion age 60 years or older at the time of enrolment DSM-5 criteria for insomnia disorder (Sleep Condition Indicator, SCI ≤ 16) subjective memory decline ability to read and understand French or English ability to use a smartphone or tablet, and access to home internet connection If on hypnotic or psychotropic medication, being on stable dosage for at least 2 months prior to study entry Exclusion located outside of Québec or Ontario current hospitalization or planned major surgery uncorrected severe hearing or vision impairment reported diagnosis of major neurocognitive disorder or mild cognitive impairment (MCI) performance suggestive of major neurocognitive disorder or MCI on T-MoCA < 17 reported diagnosis of schizophrenia or bipolar disorder reported diagnosis or positive screen on the MINI for psychotic or bipolar disorders high suicidal risk, as assessed by the modified Columbia-Suicide Severity Rating Scale reported diagnosis or positive screening for another untreated sleep disorder (e.g., sleep disordered breathing (OSA), REM sleep behavior disorder (RBD), restless legs syndrome (RLS); individuals with treated and controlled OSA or RLS will not be excluded) apnea-hypopnea index >10 on a level 3 home sleep apnea test or residual AHI >10 for individuals on CPAP current shift work currently receiving CBT frequent alcohol consumption (>10 glasses/week or 3times/week), or use of alcohol 3x/week for sleep, or use of cannabis (more than once a week) or illicit drugs (more than once a month) smoking more than 10 cigarettes/day Additional exclusion criteria for neuroimaging psychotropic (including hypnotic) medication in the past 2 weeks contraindications for MRI (e.g., pacemaker, metallic implant, claustrophobia) unable or unwilling to come to one of the participating MRI centers (Montreal, Ottawa) medical conditions likely to affect sleep; in particular: current neurological disorder (e.g., epilepsy with any seizure in the past year, concussion in the past 3 months, multiple sclerosis, Parkinson's disease) past history of brain lesion (e.g., brain hemorrhage, brain tumor, any condition having required brain surgery) major surgery (i.e., requiring general anesthesia) in the past 3 months untreated thyroid disorder chronic pain syndrome self-reported as interfering with sleep (e.g., migraine, fibromyalgia, rheumatoid arthritis) recent and severe infection in the past 3 months (e.g., pneumonia, kidney infection) active cancer or treated cancer with post-cancer treatment for less than 2 years Inclusion/exclusion criteria for good sleepers Twenty-five good sleepers without cognitive complaint will be recruited as controls for the MRI session following the same criteria described above, except that SCI ≥ 17, not meeting the diagnostic criteria for chronic insomnia as assessed by the insomnia module of the SCID and no subjective memory decline.