The primary purpose of this project is to test an environmental intervention aimed at improving nighttime sleep and decreasing daytime sleepiness among nursing home residents. The intervention will be targeted at improving disruptive environmental conditions that contribute to sleep disturbance. This 5-year project will be a randomized, controlled trial performed in 4 community nursing homes, with an expected enrollment of 120 subjects. Residents with both daytime sleepiness and nighttime sleep impairment will be targeted for the study. Subjects randomized to the treatment group will receive a daytime/nighttime (i.e., 24-hour) intervention that combines a previously-tested nighttime intervention (involving measures to decrease noise, light and sleep-disruptive nursing care practices) with a daytime intervention (involving structured sleep and awakening times, natural bright light exposure, increased physical activity, and limitation of time spent in bed). Control subjects will receive usual care. Outcome measures will include measures of sleep versus wakefulness (estimated by 24 hour wrist actigraphy) and behavior (measured by 24 hour behavioral observations). In addition, certain measures of the process of the intervention will be collected (i.e., noise levels, light exposure, in-bed time, and activity levels) to test the theoretical framework of the intervention. The major hypotheses are that the intervention will be associated with improvement in nighttime sleep and decreased daytime sleepiness and agitation. Results of this application may lead to dramatic changes in the nursing home environment, with the potential for significant improvement in the quality of life and well-being of this vulnerable population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29AG013885-02
Application #
6055426
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Project Start
1998-09-01
Project End
2003-08-31
Budget Start
1999-09-01
Budget End
2000-08-31
Support Year
2
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Martin, Jennifer L; Marler, Matthew R; Harker, Judith O et al. (2007) A multicomponent nonpharmacological intervention improves activity rhythms among nursing home residents with disrupted sleep/wake patterns. J Gerontol A Biol Sci Med Sci 62:67-72
Martin, Jennifer L; Webber, Adam P; Alam, Tarannum et al. (2006) Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home. Am J Geriatr Psychiatry 14:121-9
Martin, Jennifer L; Mory, Aaron K; Alessi, Cathy A (2005) Nighttime oxygen desaturation and symptoms of sleep-disordered breathing in long-stay nursing home residents. J Gerontol A Biol Sci Med Sci 60:104-8
Alessi, Cathy A; Martin, Jennifer L; Webber, Adam P et al. (2005) Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. J Am Geriatr Soc 53:803-10
Alessi, Cathy A; Ouslander, Joseph G; Maldague, Sandra et al. (2003) Incidence and costs of acute medical conditions in long-stay incontinent nursing home residents. J Am Med Dir Assoc 4:S4-S18
Ancoli-Israel, Sonia; Cole, Roger; Alessi, Cathy et al. (2003) The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26:342-92