Aging Clinical Trial
Official title:
Aging: Cytokine Mechanisms and Treatment of Insomnia
The purpose of this study is to evaluate whether Tai Chi Chih vs. cognitive behavioral therapy vs. sleep education reduces insomnia in older adults. The secondary goal of the study is to determine whether the behavioral treatment of insomnia alters proinflammatory cytokine activity.
Insomnia is a prominent complaint in late-life. However, little scientific effort has been
directed toward identifying the biological mechanisms that are related to abnormal sleep or
to evaluating the efficacy of behavioral treatments for insomnia in older adults. Basic
observations demonstrate that proinflammatory cytokines play a key role in the regulation of
sleep. Previous research shows that cytokines are reciprocally linked with abnormal sleep.
This trial builds upon these findings and extends a program of study that has examined the
efficacy of behavioral interventions on health outcomes in the elderly.
Preliminary studies found that Tai Chi Chih (TCC), a slow moving meditation, contributes to
improvements in subjective sleep quality, sleep amounts and sleep efficiency, alterations in
sympathetic activity, decreases in proinflammatory cytokines, and improvements in health
functioning in community-dwelling older adults. Additionally, cognitive behavior therapy
(CBT) confers benefits on sleep outcomes.
In this randomized, controlled trial, 150 older adults will be randomly assigned to CBT,
TCC, or sleep hygiene/education control (EC) over 16 weeks and followed for one year. The
aims of this project are to: 1) evaluate the effects of CBT vs TCC vs. EC on objective and
subjective measures of sleep and on fatigue, mood, and health functioning in older adults
with insomnia; 2) determine the effects of CBT vs.TCC vs. EC on measures of proinflammatory
cytokine activity and sympathovagal balance, and whether these two biological mechanisms are
related to changes of disordered sleep over the course of the treatment trial; and 3)
evaluate whether circulating levels of proinflammatory cytokines are associated with
measures of sleep continuity in older adults with insomnia over the treatment trial. This
study will advance psychobiological models of disordered sleep and the potential benefits of
two readily exportable behavioral interventions for promoting improvements in sleep outcomes
in the elderly.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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