SIESTA: Sleep Intervention to Enhance Cognitive Status and Reduce Beta Amyloid

NCT ID: NCT03954210

Last Updated: 2025-07-17

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-27

Study Completion Date

2025-04-18

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The objective of this study is to compare the efficacy of a sleep intervention on improving cognitive function in older adults with symptoms of insomnia, determine the association between change in sleep measures and change in cognitive function, and examine the efficacy of the sleep intervention on reducing the rate of Aβ deposition. Participants, ages 60-85, will be randomly assigned to a six-week sleep intervention program. A sub-group of fifty participants will undergo Florbetapir-Positron-emission tomography (PET) imaging during the one-year reassessment to examine the efficacy of the sleep intervention on reducing the rate of Aβ accumulation from baseline to one-year post-intervention.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Lifestyle interventions to increase exercise and improve diet have been the focus of recent clinical trials to potentially prevent Alzheimer's disease (AD). However, despite the strong links between sleep disruptions, cognitive decline, and AD, sleep enhancement has yet to be targeted as a lifestyle intervention to prevent AD. Approximately fifteen percent of AD may be prevented by an efficacious intervention aimed to reduce sleep disturbances and sleep disorders. Chronic insomnia is the most frequent sleep disorder occurring in at least forty percent of older adults. Individuals with insomnia are more likely to be diagnosed with AD and demonstrate a decline in cognitive function at long-term follow-up. AD is characterized by the accumulation of Aβ plaques and tau tangles in the brain, and growing evidence shows impaired sleep contributes to the accumulation of Aβ. An intervention aimed at improving insomnia may represent a critical opportunity for primary prevention to slow cognitive decline and potentially delay the onset of AD. Therefore, the long-term goal of this research agenda is to understand how addressing sleep disturbances, via sleep intervention, may delay the onset of AD.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Insomnia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers
The research assistant will be blinded to the participant's intervention group.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Six-Week CBT-I Program

CBT-I, six sessions, forty-five to sixty minutes in duration.

Session 1: set up sleep restriction and stimulus control, discuss strategies for how to stay awake to a prescribed hour and what to do with wake after onset sleep time, provide sleep hygiene education.

Session 2: determine if upward titration of total sleep time is warranted, review sleep hygiene.

Session 3: continue upward titration of total sleep time, cognitive therapy for negative sleep beliefs if indicated.

Session 4: continue upward titration of total sleep time, follow-up regarding negative sleep beliefs.

Session 5: continue upward titration of total sleep time, discuss relapse prevention.

Session 6: assess global treatment gains, discuss questions regarding relapse prevention.

Group Type EXPERIMENTAL

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Intervention Type BEHAVIORAL

CBT-I is an in-person, one-on-one program with a graduate psychology research assistant who is trained in providing a standardized CBT-I. Participants will maintain a sleep diary during the course of the program to aid in tailoring the program. Each session will begin with a summary and graphing of sleep diary data and will include an assessment of treatment gains and adherence.

Six-Week Sleep and Lifestyle Education Program

Sleep and Lifestyle Education, six sessions, forty-five to sixty minutes in duration.

Session 1: Sleep education, Instruction/demonstration on stretching exercises.

Session 2: Education on environmental factors \& sleeping positions that impact sleep.

Session 3: Education on lifestyle factors that impact sleep.

Session 4: Education on diet and sleep.

Session 5: Education on exercises and sleep.

Session 6: Discus maintaining achievements \& preventing relapses.

Group Type ACTIVE_COMPARATOR

Sleep and Lifestyle Education

Intervention Type BEHAVIORAL

Participants in the sleep and lifestyle education group will attend six weekly, in-person, one-on-one, stretching, and thinking activity sessions with a graduate research assistant to control for socialization and contact with research personnel.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is an in-person, one-on-one program with a graduate psychology research assistant who is trained in providing a standardized CBT-I. Participants will maintain a sleep diary during the course of the program to aid in tailoring the program. Each session will begin with a summary and graphing of sleep diary data and will include an assessment of treatment gains and adherence.

Intervention Type BEHAVIORAL

Sleep and Lifestyle Education

Participants in the sleep and lifestyle education group will attend six weekly, in-person, one-on-one, stretching, and thinking activity sessions with a graduate research assistant to control for socialization and contact with research personnel.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Report of difficulty falling asleep, maintaining sleep, or waking up too early at least three nights a week for the past six months
* A score of greater than, or equal to, ten on the Insomnia Severity Index
* A score of greater than, or equal to, twenty-five on the Mini-Mental State Examination (MMSE)
* A score of less than, or equal to, two on the Dementia Screening Interview (AD8)

Exclusion Criteria

* A known untreated sleep disorder (i.e., sleep apnea or restless leg syndrome)
* Currently taking benzodiazepines, non-benzodiazepines, melatonin supplements, or agonists for insomnia
* A score of greater than, or equal to, fifteen on the Patient Health Questionnaire (PHQ-9) indicating severe depression or endorsement of any suicidal ideation (an answer of one, two, or three on item number nine of the PHQ-9)
* History of drug or alcohol abuse as defined by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-4) criteria within the last two years
* History of a nervous system disorder (i.e., stroke, Parkinson's Disease)
* Severe mental illness (i.e., Schizophrenia, Bipolar Disorder)
* History of a learning disability or attention-deficit/hyperactivity disorder
* Current, or history of, shift work
* Currently receiving CBT-I treatment
* Unable to hear at a conversational level
* Failure of a near vision test utilizing the Logarithmic Near Visual Acuity Chart
Minimum Eligible Age

60 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

University of Kansas Medical Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Catherine Siengsukon, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Kansas Medical Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Kansas Medical Center- Sleep, Health and Wellness Laboratory

Kansas City, Kansas, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Solomon A, Mangialasche F, Richard E, Andrieu S, Bennett DA, Breteler M, Fratiglioni L, Hooshmand B, Khachaturian AS, Schneider LS, Skoog I, Kivipelto M. Advances in the prevention of Alzheimer's disease and dementia. J Intern Med. 2014 Mar;275(3):229-50. doi: 10.1111/joim.12178.

Reference Type BACKGROUND
PMID: 24605807 (View on PubMed)

Wang J, Tan L, Yu JT. Prevention Trials in Alzheimer's Disease: Current Status and Future Perspectives. J Alzheimers Dis. 2016;50(4):927-45. doi: 10.3233/JAD-150826.

Reference Type BACKGROUND
PMID: 26836177 (View on PubMed)

Bubu OM, Brannick M, Mortimer J, Umasabor-Bubu O, Sebastiao YV, Wen Y, Schwartz S, Borenstein AR, Wu Y, Morgan D, Anderson WM. Sleep, Cognitive impairment, and Alzheimer's disease: A Systematic Review and Meta-Analysis. Sleep. 2017 Jan 1;40(1). doi: 10.1093/sleep/zsw032.

Reference Type BACKGROUND
PMID: 28364458 (View on PubMed)

Alessi C, Vitiello MV. Insomnia (primary) in older people: non-drug treatments. BMJ Clin Evid. 2015 May 13;2015:2302.

Reference Type BACKGROUND
PMID: 25968443 (View on PubMed)

Lobo A, Lopez-Anton R, de-la-Camara C, Quintanilla MA, Campayo A, Saz P; ZARADEMP Workgroup. Non-cognitive psychopathological symptoms associated with incident mild cognitive impairment and dementia, Alzheimer's type. Neurotox Res. 2008 Oct;14(2-3):263-72. doi: 10.1007/BF03033815.

Reference Type BACKGROUND
PMID: 19073431 (View on PubMed)

Osorio RS, Pirraglia E, Aguera-Ortiz LF, During EH, Sacks H, Ayappa I, Walsleben J, Mooney A, Hussain A, Glodzik L, Frangione B, Martinez-Martin P, de Leon MJ. Greater risk of Alzheimer's disease in older adults with insomnia. J Am Geriatr Soc. 2011 Mar;59(3):559-62. doi: 10.1111/j.1532-5415.2010.03288.x. No abstract available.

Reference Type BACKGROUND
PMID: 21391952 (View on PubMed)

Cricco M, Simonsick EM, Foley DJ. The impact of insomnia on cognitive functioning in older adults. J Am Geriatr Soc. 2001 Sep;49(9):1185-9. doi: 10.1046/j.1532-5415.2001.49235.x.

Reference Type BACKGROUND
PMID: 11559377 (View on PubMed)

Ju YE, Lucey BP, Holtzman DM. Sleep and Alzheimer disease pathology--a bidirectional relationship. Nat Rev Neurol. 2014 Feb;10(2):115-9. doi: 10.1038/nrneurol.2013.269. Epub 2013 Dec 24.

Reference Type BACKGROUND
PMID: 24366271 (View on PubMed)

Branger P, Arenaza-Urquijo EM, Tomadesso C, Mezenge F, Andre C, de Flores R, Mutlu J, de La Sayette V, Eustache F, Chetelat G, Rauchs G. Relationships between sleep quality and brain volume, metabolism, and amyloid deposition in late adulthood. Neurobiol Aging. 2016 May;41:107-114. doi: 10.1016/j.neurobiolaging.2016.02.009. Epub 2016 Feb 17.

Reference Type BACKGROUND
PMID: 27103523 (View on PubMed)

Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard M. Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct 18;342(6156):373-7. doi: 10.1126/science.1241224.

Reference Type BACKGROUND
PMID: 24136970 (View on PubMed)

Wang MY, Wang SY, Tsai PS. Cognitive behavioural therapy for primary insomnia: a systematic review. J Adv Nurs. 2005 Jun;50(5):553-64. doi: 10.1111/j.1365-2648.2005.03433.x.

Reference Type BACKGROUND
PMID: 15882372 (View on PubMed)

Geiger-Brown JM, Rogers VE, Liu W, Ludeman EM, Downton KD, Diaz-Abad M. Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis. Sleep Med Rev. 2015 Oct;23:54-67. doi: 10.1016/j.smrv.2014.11.007. Epub 2014 Nov 29.

Reference Type BACKGROUND
PMID: 25645130 (View on PubMed)

Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Aug 4;163(3):191-204. doi: 10.7326/M14-2841.

Reference Type BACKGROUND
PMID: 26054060 (View on PubMed)

Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis. JAMA Intern Med. 2015 Sep;175(9):1461-72. doi: 10.1001/jamainternmed.2015.3006.

Reference Type BACKGROUND
PMID: 26147487 (View on PubMed)

Diekelmann S, Wilhelm I, Born J. The whats and whens of sleep-dependent memory consolidation. Sleep Med Rev. 2009 Oct;13(5):309-21. doi: 10.1016/j.smrv.2008.08.002. Epub 2009 Feb 28.

Reference Type BACKGROUND
PMID: 19251443 (View on PubMed)

CDC. Insufficient sleep is a public health problem. http://www.cdc.gov/features/dssleep/. Accessed 1/29/16.

Reference Type BACKGROUND

Hahn EA, Wang HX, Andel R, Fratiglioni L. A change in sleep pattern may predict Alzheimer disease. Am J Geriatr Psychiatry. 2014 Nov;22(11):1262-71. doi: 10.1016/j.jagp.2013.04.015. Epub 2013 Aug 14.

Reference Type BACKGROUND
PMID: 23954041 (View on PubMed)

Lim AS, Kowgier M, Yu L, Buchman AS, Bennett DA. Sleep Fragmentation and the Risk of Incident Alzheimer's Disease and Cognitive Decline in Older Persons. Sleep. 2013 Jul 1;36(7):1027-1032. doi: 10.5665/sleep.2802.

Reference Type BACKGROUND
PMID: 23814339 (View on PubMed)

Ju YE, McLeland JS, Toedebusch CD, Xiong C, Fagan AM, Duntley SP, Morris JC, Holtzman DM. Sleep quality and preclinical Alzheimer disease. JAMA Neurol. 2013 May;70(5):587-93. doi: 10.1001/jamaneurol.2013.2334.

Reference Type BACKGROUND
PMID: 23479184 (View on PubMed)

Bero AW, Yan P, Roh JH, Cirrito JR, Stewart FR, Raichle ME, Lee JM, Holtzman DM. Neuronal activity regulates the regional vulnerability to amyloid-beta deposition. Nat Neurosci. 2011 Jun;14(6):750-6. doi: 10.1038/nn.2801. Epub 2011 May 1.

Reference Type BACKGROUND
PMID: 21532579 (View on PubMed)

Varga AW, Wohlleber ME, Gimenez S, Romero S, Alonso JF, Ducca EL, Kam K, Lewis C, Tanzi EB, Tweardy S, Kishi A, Parekh A, Fischer E, Gumb T, Alcolea D, Fortea J, Lleo A, Blennow K, Zetterberg H, Mosconi L, Glodzik L, Pirraglia E, Burschtin OE, de Leon MJ, Rapoport DM, Lu SE, Ayappa I, Osorio RS. Reduced Slow-Wave Sleep Is Associated with High Cerebrospinal Fluid Abeta42 Levels in Cognitively Normal Elderly. Sleep. 2016 Nov 1;39(11):2041-2048. doi: 10.5665/sleep.6240.

Reference Type BACKGROUND
PMID: 27568802 (View on PubMed)

Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004 Nov 1;27(7):1255-73. doi: 10.1093/sleep/27.7.1255.

Reference Type BACKGROUND
PMID: 15586779 (View on PubMed)

Merica H, Blois R, Gaillard JM. Spectral characteristics of sleep EEG in chronic insomnia. Eur J Neurosci. 1998 May;10(5):1826-34. doi: 10.1046/j.1460-9568.1998.00189.x.

Reference Type BACKGROUND
PMID: 9751153 (View on PubMed)

Pigeon WR, Perlis ML. Sleep homeostasis in primary insomnia. Sleep Med Rev. 2006 Aug;10(4):247-54. doi: 10.1016/j.smrv.2005.09.002. Epub 2006 Mar 24.

Reference Type BACKGROUND
PMID: 16563817 (View on PubMed)

Cervena K, Dauvilliers Y, Espa F, Touchon J, Matousek M, Billiard M, Besset A. Effect of cognitive behavioural therapy for insomnia on sleep architecture and sleep EEG power spectra in psychophysiological insomnia. J Sleep Res. 2004 Dec;13(4):385-93. doi: 10.1111/j.1365-2869.2004.00431.x.

Reference Type BACKGROUND
PMID: 15560773 (View on PubMed)

Foley D, Monjan A, Masaki K, Ross W, Havlik R, White L, Launer L. Daytime sleepiness is associated with 3-year incident dementia and cognitive decline in older Japanese-American men. J Am Geriatr Soc. 2001 Dec;49(12):1628-32. doi: 10.1046/j.1532-5415.2001.t01-1-49271.x.

Reference Type BACKGROUND
PMID: 11843995 (View on PubMed)

Kreutzmann JC, Havekes R, Abel T, Meerlo P. Sleep deprivation and hippocampal vulnerability: changes in neuronal plasticity, neurogenesis and cognitive function. Neuroscience. 2015 Nov 19;309:173-90. doi: 10.1016/j.neuroscience.2015.04.053. Epub 2015 Apr 29.

Reference Type BACKGROUND
PMID: 25937398 (View on PubMed)

Mitchell MD, Gehrman P, Perlis M, Umscheid CA. Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review. BMC Fam Pract. 2012 May 25;13:40. doi: 10.1186/1471-2296-13-40.

Reference Type BACKGROUND
PMID: 22631616 (View on PubMed)

Musiek ES, Xiong DD, Holtzman DM. Sleep, circadian rhythms, and the pathogenesis of Alzheimer disease. Exp Mol Med. 2015 Mar 13;47(3):e148. doi: 10.1038/emm.2014.121.

Reference Type BACKGROUND
PMID: 25766617 (View on PubMed)

Vitiello MV, McCurry SM, Shortreed SM, Balderson BH, Baker LD, Keefe FJ, Rybarczyk BD, Von Korff M. Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. J Am Geriatr Soc. 2013 Jun;61(6):947-956. doi: 10.1111/jgs.12275. Epub 2013 May 27.

Reference Type BACKGROUND
PMID: 23711168 (View on PubMed)

McCurry SM, Shortreed SM, Von Korff M, Balderson BH, Baker LD, Rybarczyk BD, Vitiello MV. Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the Lifestyles trial. Sleep. 2014 Feb 1;37(2):299-308. doi: 10.5665/sleep.3402.

Reference Type BACKGROUND
PMID: 24497658 (View on PubMed)

Hand LK, Key MN, Vidoni ED, Ludwig R, Nelson E, Glaser A, Drerup M, Phadnis MA, Bruce J, Burns JM, Siengsukon CF. Sleep Fragmentation and Sleep Stages 1 and 2 Are Associated With Amyloid-Beta Burden in Cognitively Normal Older Adults. J Sleep Res. 2025 Jun 3:e70098. doi: 10.1111/jsr.70098. Online ahead of print.

Reference Type DERIVED
PMID: 40461009 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

R01AG058530

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY00143545

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Remote STATE Training for Insomnia in Older Adults
NCT06589024 ACTIVE_NOT_RECRUITING NA
Mindfulness Meditation for Insomnia
NCT06972303 RECRUITING PHASE1/PHASE2
Sleep Interventions and Neurocognitive Outcomes
NCT05987007 NOT_YET_RECRUITING NA
Optimizing Sleep Health in Nurses
NCT05965609 RECRUITING NA
Digital CBT-I for Chronic Insomnia
NCT06695000 NOT_YET_RECRUITING NA