Clinical Interventions in Aging (Dec 2023)
The Effect of Tele-Savvy on Sleep Quality and Insomnia in Caregivers of Persons Living with Dementia
Abstract
Glenna S Brewster,1 Melinda Higgins,1 Miranda Varrasse McPhillips,2 Kalisha Bonds Johnson,1 Fayron Epps,1 Katherine A Yeager,1 Donald L Bliwise,3 Kenneth Hepburn1 1Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA; 2University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; 3Division of Sleep Medicine, Emory University School of Medicine, Atlanta, GA, USACorrespondence: Glenna S Brewster, 1520 Clifton Road, NE, Atlanta, GA, 30322-4027, USA, Tel +1 404.712.9164, Email [email protected]: Sleep disturbance is prevalent in caregivers of persons living with dementia (PLwD). Tele-Savvy, a 7-week virtual psychoeducational intervention, enhances caregivers’ competence and self-care, and reduces depression. While not explicitly designed to do so, Tele-Savvy can potentially improve caregivers’ disturbed sleep. The present study aimed to examine the longitudinal effects of Tele-Savvy on caregivers’ sleep quality and insomnia.Methods: This was a secondary data analysis of a 3-arm randomized control trial [Tele-Savvy (active treatment), Healthy Living (attention control), and usual care (waitlist control)]. Multilevel mixed modeling with intent-to-treat principles tested for group, time, and group-by-time effects. Effect sizes were estimated for all changes from baseline to the initial 6-month post-intervention point. Following completion of the 6-month post-randomization delay, we examined combined outcomes for Tele-Savvy.Results: Participants (n=137; mean age 64.7 years) were predominantly female (68.6%) and White (68.6%). We found no initial group-by-time effects for the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). For the combined Tele-Savvy group, there was a statistically significant improvement in ISI scores across time (p=0.050). The combined Tele-Savvy effect size for PSQI was d=0.126 and ISI was d=0.310.Discussion: Tele-Savvy resulted in a significant long-term reduction in insomnia symptoms in this sample of caregivers of PLwD and demonstrated a positive trend for improvement in their sleep quality. Since sleep disturbance is so prevalent among caregivers of PLwD, the inclusion of sleep health education into psychoeducation caregiver interventions may yield even better outcomes for caregivers.Plain Language Summary: Many caregivers of persons living with dementia have poor sleep. Tele-Savvy is a 7-week intervention that was delivered online to caregivers improved their caregiving skills and self-care and reduced their depressive symptoms; thus, Tele-Savvy may possibly improve their sleep problems. This study aimed to examine the effects of Tele-Savvy on caregivers’ sleep quality and insomnia over 6 months. Caregivers were randomly assigned to Tele-Savvy (intervention), Healthy Living (comparison intervention), and usual care (no initial intervention). One hundred and thirty-seven caregivers, predominantly female, who were on average 64.7 years, participated in this study and completed measures of insomnia and sleep quality. Insomnia symptoms improved and there was a positive trend for improved sleep quality across time for caregivers who received Tele-Savvy. Since so many caregivers have sleep problems, including sleep health education as a part of other caregiver interventions may lead to even better outcomes for caregivers.Keywords: psychoeducational intervention, Alzheimer’s disease, circadian rhythm, cognitive behavioral therapy for insomnia, depression
