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Cognitive behavioural interventions for sleep problems in adults aged 60+.
1The University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital, Old Road, Headington, Oxford, UK, OX3 7LQ. paul.montgomery@psych.ox.ac.uk
The Cochrane Database of Systematic Reviews
|January 22, 2003
Summary
Cognitive-behavioural treatments (CBT) show a mild effect in improving sleep problems for older adults, particularly for sleep maintenance insomnia. This non-pharmacological approach offers an alternative to hypnotics, though further research on predictors of success and long-term durability is needed.
Area of Science:
- Gerontology
- Sleep Medicine
- Behavioral Science
Background:
- Sleep problems increase with age, potentially leading to depression, cognitive decline, and reduced quality of life.
- Pharmacological treatments are common for insomnia, but non-drug interventions like cognitive and behavioural treatments (CBT) offer an alternative without drug-related tolerance or dependency.
- CBT for sleep aims to improve sleep by modifying habits, enhancing sleep hygiene, and addressing negative thoughts about sleep.
Purpose of the Study:
- To evaluate the effectiveness of cognitive-behavioural interventions in enhancing sleep quality, duration, and efficiency in older adults (aged 60 and above).
Main Methods:
- A systematic search of multiple databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Library, NRR) was conducted.
- Included randomized controlled trials focused on primary insomnia in participants aged 60+, excluding those with dementia or depression.
- Data from six trials involving 224 participants were meta-analyzed, distinguishing between subjective and objective sleep outcome measures.
Main Results:
- Cognitive-behavioural treatments (CBT) demonstrated a mild positive effect on sleep problems in older adults.
- The benefits of CBT were most apparent for sleep maintenance insomnia.
- Six trials with a total of 224 participants were included in the meta-analysis.
Conclusions:
- CBT presents a viable clinical option for sleep disorders in older adults, especially when considering the side effects of hypnotic medications.
- Further research is required to identify predictors of successful CBT outcomes in this population.
- Investigating the long-term durability of CBT effects and the potential benefit of refresher sessions is recommended.