Our primary purpose is to determine whether a combined intervention is effective in improving sleep in caregivers of PWD who arise at night. The intervention consists of a night home monitoring system that provides reliable alerts to caregivers when persons with dementia (PWD) leave the bed and move through the house. While this system improved home safety for PWD, it did not affect caregiver sleep, so a more traditional sleep therapy will be added—cognitive-behavioral therapy for insomnia (CBTi). In the proposed study, experimental participants will receive the night home monitoring system + CBTi; control participants will receive only the night home monitoring system. Participants will remain in the study for 24 weeks, with 4 data collection points. We hypothesize experimental participants will have less time awake after going to bed, and improved sleep efficiency (percent time asleep while in bed). Sleep data will be collected for multiple nights using actigraphy and sleep diary. Our secondary research questions focus on the relationship between poor sleep and coronary heart disease (CHD). Both in adults and in dementia caregivers (CG), there appears to be a link between poor sleep and abnormal levels on coronary heart disease biomarkers, and likely an increase in CHD with poor sleep. We aim to further explore this relationship as well as determine whether levels of biomarkers improve with improved sleep from the intervention. We propose to draw blood samples at 3 data collection points and measure a set of biomarkers indicative of CHD. Our primary expected outcome is an effective, easy-to-use treatment that can improve sleep in dementia CGs with sleep problems. We will continue to build the science on the relationship between sleep and CHD, and to understand mechanisms that may underlie deleterious changes in CG health.
Public Health Relevance
Obtaining evidence of the relationship between sleep and CHD biomarkers, supported by preliminary data that improving sleep reverses changes in biomarker levels, would begin to fill a critically important gap in research aiming to reduce the trend of PWD caregiver mortality and CHD as well as PWD placement in nursing homes.