0384 Impact of Brief Behavioral Treatment for Insomnia (BBTi) on Meta-Cognition in Older Adults

Abstract

Introduction: Evidence links insomnia to both objective and subjective cognitive disruption in older adults. Brief (<5 sessions) behavioral treatment for insomnia (BBTi) improves insomnia in older adults with insomnia (OAWI). Whether BBTi improves cognition is unclear, with our prior trial reporting no effects on objective cognition. Meta‐cognition (subjective appraisal of one's own performance) has not been examined. This study examines the effects of BBTi on meta‐cognition in OAWI. Methods: Older adults with chronic insomnia [N=62, Mage=69.45(SD=7.71)] were randomized to 4‐weeks of BBTi (n=32;education, sleep hygiene, stimulus control, sleep restriction, relaxation) or self‐monitoring control (SMC;n=30). Meta‐cognition was assessed daily and two‐week averages were calculated for baseline, treatment‐first half, treatment‐second half, post‐treatment, and 3‐month follow‐up. Participants completed daily cognitive tasks and then rated meta‐cognition (0‐worst, 100‐best) in four areas: quality, satisfaction, compared to same age peers, compared to their own ability. Multilevel Modeling examined treatment effects (BBTi, SMC) over time on meta‐cognition, controlling for age and gender. Results: A significant group by time interaction (F=2.41, p≤.05) revealed consistent improvements in ratings of better cognitive performance relative to same age peers for BBTi over time, relative to baseline; SMC prompted inconsistent improvements that were not maintained at follow‐up. Significant main effects of time for the other meta‐cognition variables (all ps