Preliminary efficacy of an internet-delivered behavioral intervention for insomnia in individuals with mild cognitive impairment

Abstract

BACKGROUND: Insomnia is present in up to 50% of older adults with cognitive impairment. When insomnia is left untreated, pre-existing cognitive problems may be exacerbated and potentially contribute to further cognitive decline. One promising approach to improve cognitive health in individuals with cognitive impairment is to improve quantity and quality of sleep. Our objective was to determine preliminary efficacy of an Internet-delivered cognitive behavioral therapy for insomnia program in older adults with mild cognitive impairment (MCI). METHOD: Older adults with MCI and insomnia were recruited from hospital-based memory and sleep disorders clinics and enrolled in a single-arm intervention pilot study. Participants completed the Internet-delivered, six-part CBT-I intervention over nine weeks with two-week pre- and post-assessments using self-reported sleep diaries. Preliminary efficacy was informed by patient-generated data on sleep parameters. RESULT: Twelve participants enrolled and, on average, were 75.8 years of age with a 7.5-year history of sleep difficulties. There were significant differences found on all pre- to post-assessment sleep measures. Most notably, there were clinically meaningful changes in insomnia severity index (13.5 to 8.3, p .05). CONCLUSION: Results provide evidence that older adults with cognitive impairment can complete CBT-I via the internet and achieve clinical improvements in their sleep.