This study will test the efficacy of a technology-enhanced home behavioral treatment (THBT) or older adults with insomnia and comorbid chronic illness. The SBIR 1 study found that THBT yielded short-term reductions in insomnia compared to no treatment. These benefits were comparable to those obtained from a classroom treatment at much less cost. The goal of the proposed study will be extend these findings using a more precise methodology, measurement of longer-term benefits, and comparison to an alternative self-help treatment. Subjects will include 80 older adults with one of two common chronic diseases with high rates of comorbid insomnia: osteoarthritis and coronary artery disease. They will receive one of the two treatments: THBT with video instruction on cognitive-behavioral (CB) techniques and 3-D audio relaxation training; or bibliotherapy treatment using a previously tested CB self-help book. Outcomes will be assessed at post-treatment and 1 year follow-up using objective and self-report measures of sleep. Quality of life, functional status and health care utilization benefits will be assessed. This study complements an R01 proposal by the co-investigators which includes a classroom CB treatment and a placebo treatment, thus allowing for outcome comparisons across a continuum of behavioral treatment modalities. An easy-to-use home treatment package would have strong potential as a first-line treatment for geriatric insomnia.
|Rybarczyk, Bruce; Mack, Laurin; Harris, Jennifer Huang et al. (2011) Testing two types of self-help CBT-I for insomnia in older adults with arthritis or coronary artery disease. Rehabil Psychol 56:257-66|