Using Behavioral Programs to Treat Sleep Problems in Individuals With Alzheimer's Disease

NCT ID: NCT00183378

Last Updated: 2012-01-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-09-30

Study Completion Date

2011-03-31

Brief Summary

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This study will compare four different behavioral treatment programs to determine which is most effective in reducing night-time disturbances in individuals with Alzheimer's disease (AD).

Detailed Description

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Nocturnal disturbances, such as getting out of bed repeatedly, having hallucinations, talking or singing in bed, and waking up confused are common among patients with AD. Such nocturnal disturbances are associated with increased physical and psychological morbidity in both AD patients and their caregivers and are a major risk factor for patient institutionalization. Nonpharmacologic treatments for these disturbances are needed. This study will assign AD patients to one of four different treatments to determine which is most effective in reducing nocturnal disturbances.

This study will last 6 months. Participants will be randomly assigned to a walking program, a light exposure program, a "NITE-AD" program, combining the walking and light exposure programs, or routine AD care with nocturnal disturbance education. Walking program participants will have three 1-hour visits with a therapist over an 8-week period. The therapist and the participant will set an initial daily walking goal and develop a plan for gradually increasing the participants' walking to 30 minutes/day, to be increased at a participant-selected pace. Pedometers will be given to participants to monitor daily activity. The therapist will also discuss exercise safety and will review ways to prevent muscle soreness. Light program participants will also have three 1-hour visits with a therapist over 8 weeks. The therapist will develop a daily, caregiver-supervised light exposure plan requiring participants to sit in front of a light box for 1 hour every day. NITE-AD program participants will have six 1-hour visits with a therapist over 8 weeks; their visits will include setting up both walking and the light exposure routines. Participants assigned to education will receive information about about sleep in aging and dementia, but no assistance setting up walking or light exposure plans.

Participants will be assessed at study entry and at Months 2 (post-test) and 6. The sleep patterns of both the patients and the caregivers will be measured. Caregiver reports of patients' night-time behavioral disturbances and readings from an actigraph, a small electronic device worn by participants that records and reports their levels of activity at night, will be used to estimate sleep. The study will also collect data on patient and caregiver mood, stress, and behavior. A follow-up visit will occur 6 months after study completion; at the follow-up visit, the same outcome measures will be collected as at baseline and post-test. Participants will receive 3 biannual phone follow-ups (12, 18, and 24 months) to assess patient residential status and caregiver reports of patient and caregiver sleep.

Conditions

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Alzheimer Disease Sleep Initiation and Maintenance Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Routine medical care with education: therapist provides information about the nature of sleep changes in people with Alzheimer's disease, general information about treatments for insomnia, and caregiver support.

Group Type ACTIVE_COMPARATOR

Routine Medical Care with Education

Intervention Type BEHAVIORAL

The therapist provides information about the nature of sleep changes in people with Alzheimer's disease, general information about treatments for insomnia, and caregiver support. Participants are free to use whatever medical services they wish during study participation.

2

Walking: the therapist introduces a walking program and assists the caregiver in establishing a daily walking routine of 30 minutes for the study participant.

Group Type ACTIVE_COMPARATOR

Walking Program

Intervention Type BEHAVIORAL

The therapist introduces a walking program and assists the caregiver in establishing a walking routine of 30 minutes/day for the study participant.

3

Light exposure: the therapist provides a light box and teaches the caregiver how to use the box so that the study participant's daily exposure to bright light is one hour.

Group Type ACTIVE_COMPARATOR

Light Exposure Program

Intervention Type BEHAVIORAL

The therapist provides a light box and teaches the caregiver how to use the box so that the study participant's daily exposure to bright light is one hour.

4

Combination: the therapist provides education plus assistance setting up an individualized sleep program, a daily walking routine, and a schedule for daily light exposure.

Group Type ACTIVE_COMPARATOR

Combined Education, Walking and Light Exposure Program

Intervention Type BEHAVIORAL

The therapist provides a combination of education plus assistance setting up an individualized sleep program, a daily walking routine, and a schedule for daily light exposure.

Interventions

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Walking Program

The therapist introduces a walking program and assists the caregiver in establishing a walking routine of 30 minutes/day for the study participant.

Intervention Type BEHAVIORAL

Light Exposure Program

The therapist provides a light box and teaches the caregiver how to use the box so that the study participant's daily exposure to bright light is one hour.

Intervention Type BEHAVIORAL

Combined Education, Walking and Light Exposure Program

The therapist provides a combination of education plus assistance setting up an individualized sleep program, a daily walking routine, and a schedule for daily light exposure.

Intervention Type BEHAVIORAL

Routine Medical Care with Education

The therapist provides information about the nature of sleep changes in people with Alzheimer's disease, general information about treatments for insomnia, and caregiver support. Participants are free to use whatever medical services they wish during study participation.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of probable or possible Alzheimer's Disease
* Have at least two sleep disturbances, occurring 3 or more times per week
* Reside in a residential home with a family member caregiver
* Able to walk without assistance


* Currently caring for a family member with Alzheimer's disease

Exclusion Criteria

* Pre-existing diagnosis of a primary sleep disorder, such as sleep apnea or periodic limb movement disorder
* Blindness
* Current use of photosensitizing medication
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Sue McCurry

Research Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Susan M. McCurry, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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McCurry SM, Gibbons LE, Logsdon RG, Vitiello M, Teri L. Training caregivers to change the sleep hygiene practices of patients with dementia: the NITE-AD project. J Am Geriatr Soc. 2003 Oct;51(10):1455-60. doi: 10.1046/j.1532-5415.2003.51466.x.

Reference Type BACKGROUND
PMID: 14511168 (View on PubMed)

McCurry SM, Gibbons LE, Logsdon RG, Vitiello MV, Teri L. Nighttime insomnia treatment and education for Alzheimer's disease: a randomized, controlled trial. J Am Geriatr Soc. 2005 May;53(5):793-802. doi: 10.1111/j.1532-5415.2005.53252.x.

Reference Type BACKGROUND
PMID: 15877554 (View on PubMed)

McCurry SM, Pike KC, Logsdon RG, Vitiello MV, Larson EB, Teri L. Predictors of short- and long-term adherence to a daily walking program in persons with Alzheimer's disease. Am J Alzheimers Dis Other Demen. 2010 Sep;25(6):505-12. doi: 10.1177/1533317510376173. Epub 2010 Jul 26.

Reference Type RESULT
PMID: 20660515 (View on PubMed)

McCurry SM, Pike KC, Vitiello MV, Logsdon RG, Larson EB, Teri L. Increasing walking and bright light exposure to improve sleep in community-dwelling persons with Alzheimer's disease: results of a randomized, controlled trial. J Am Geriatr Soc. 2011 Aug;59(8):1393-402. doi: 10.1111/j.1532-5415.2011.03519.x. Epub 2011 Jul 28.

Reference Type RESULT
PMID: 21797835 (View on PubMed)

Other Identifiers

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R01MH072736

Identifier Type: NIH

Identifier Source: secondary_id

View Link

DATR A4-GPS

Identifier Type: -

Identifier Source: secondary_id

R01MH072736

Identifier Type: NIH

Identifier Source: org_study_id

View Link

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