0387 Sleep-SMART for Veterans with Mild Cognitive Impairment (MCI) and Insomnia: A Pilot Study

Abstract

Introduction: Mild cognitive impairment (MCI) is an important public health concern for aging Veterans as it is a known risk factor for progression to dementia. Insomnia is common in MCI occurring in up to 60% of patients. Cognitive Behavioral Therapy for Insomnia (CBT‐I) is the recommended treatment for insomnia, however, cognitive impairments experienced by individuals with MCI may limit the ability of some individuals to adequately understand and actively participate in CBT‐I. In this study a modified CBT‐I treatment Sleep‐SMART (Sleep Symptom Management and Rehabilitation Therapy) was developed and pilot tested with Veteran input. Sleep‐SMART incorporates supportive cognitive strategies into a CBT‐I protocol to enhance CBT‐I learning and adherence. Methods: 14 Veterans completed the 6‐week Sleep‐SMART intervention. Each participant was assessed on the Insomnia Severity Index (ISI) and the Pittsburgh Quality Sleep Index (PSQI) at pre‐ and post‐treatment (Weeks 0 and 6 respectively). Veterans also completed weekly sleep diaries for the duration of the 6‐weeks of treatment. Independent t‐tests were performed comparing pre and post‐treatment scores for the ISI, PSQI, and sleep diary variables (sleep efficiency [SE], total sleep time [TST], sleep latency [SL], wake after sleep onset [WASO], and early morning awakening [EMA]). Treatment acceptability was examined using the average rating on the Acceptability of Intervention Measure (AIM; 1‐5‐point Likert type scale, with higher scores indicating greater acceptability). Results: Participants (11M/3F, age=71.8+/‐6.9yrs) showed significant symptom improvement on both ISI (pre=18.25/ post=10.83,p