Browse > Article
http://dx.doi.org/10.14401/KASMED.2018.25.2.74

The Effects of a Brief Intervention for Insomnia on Community Dwelling Older Adults  

Oh, Eui Sun (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Park, Kyung Mee (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
An, Suk Kyoon (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Namkoong, Kee (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Shim, Da-hye (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Lee, Eun (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Publication Information
Sleep Medicine and Psychophysiology / v.25, no.2, 2018 , pp. 74-81 More about this Journal
Abstract
Objectives: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. Methods: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. Results: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. Conclusion: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.
Keywords
Cognitive behavioral therapy for insomnia; Community; Elderly; Insomnia; Sleep;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Smith MT, Perlis ML, Park A, Smith MS, Pennington J, Giles DE, et al. Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. Am J Psychiatry 2002;159:5-11.   DOI
2 Troxel WM, Germain A, Buysse DJ. Clinical management of insomnia with brief behavioral treatment (BBTI). Behav Sleep Med 2012;10:266-279.   DOI
3 Verbeek IH, Konings GM, Aldenkamp AP, Declerck AC, Klip EC. Cognitive behavioral treatment in clinically referred chronic insomniacs: group versus individual treatment. Behav Sleep Med 2006;4:135-151.   DOI
4 Vitiello MV, McCurry SM, Rybarczyk BD. The future of cognitive behavioral therapy for insomnia: what important research remains to be done? J Clin Psychol 2013;69:1013-1021.   DOI
5 Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37-49.   DOI
6 Abler RM. Cognitive/behavioral and relational/interpersonal group counseling: Effects of an eight-week approach on affective status among independent-living elderly adults. Dissertation Abstract International 1990;51:969B.
7 Ahn S, Choi H, Kim H, Kim J. Prevalence of insomnia and associated factors among community-dwelling Korean elderly. J Korean Geriatr Psychiatry 2015;19:32-39.
8 Avidan AY. Sleep disorders in the older patient. Prim Care 2005;32:563-586.   DOI
9 Alessi CA, Martin JL, Webber AP, Cynthia Kim E, Harker JO, Josephson KR. Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. J Am Geriatr Soc 2005;53:803-810.   DOI
10 Ancoli-Israel S, Ayalon L, Salzman C. Sleep in the elderly: normal variations and common sleep disorders. Harv Rev Psychiatry 2008;16:279-286.   DOI
11 Brabbins C, Dewey M, Copeland J, Davidson I, McWilliam C, Saunders P, et al. Insomnia in the elderly: prevalence, gender differences and relationships with morbidity and mortality. Int J Geriatr Psychiatry 1993;8:473-480.   DOI
12 Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med 2011;171:887-895.   DOI
13 Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.   DOI
14 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-383.   DOI
15 Cho M, Bae J, Suh G, Hahm B, Kim J, Lee D et al. Validation of geriatric depression scale, Korean version (GDS) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 1999;38:1.
16 Cho Y, Kim E. Psychometric properties of the Korean version of the anxiety control questionnaire. Kor J Clin Psychol 2004;23:503-518.
17 Hamblin JE. Insomnia: an ignored health problem. Prim Care 2007; 34:659-674, viii.   DOI
18 Espie CA. "Stepped care": a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment. Sleep 2009;32:1549-1558.   DOI
19 Espie CA, Inglis SJ, Tessier S, Harvey L. The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behav Res Ther 2001;39:45-60.   DOI
20 Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18:425-432.   DOI
21 Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the sleep hygiene index. J Behav Med 2006;29:223-227.   DOI
22 Mintz J, Steuer J, Jarvik L. Psychotherapy with depressed elderly patients: research considerations. J Consult Clin Psychol 1981;49:542-548.   DOI
23 Morin CM. Insomnia: Psychological Assessment and Management, Guilford Press;1993.
24 Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002;6:97-111.   DOI
25 Riemann D, Spiegelhalder K, Espie C, Pollmacher T, Leger D, Bassetti C, et al. Chronic insomnia: clinical and research challenges--an agenda. Pharmacopsychiatry 2011;44:1-14.   DOI
26 Seo W-S. Behavior therapy and light therapy of insomnia. Sleep Med Psychophysiol 2003;10:20-25.
27 Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008;4:487-504.