Web-based Cognitive Behavior Therapy for Insomnia (CBT-I) for Chronic Insomnia
Study Summary
This trial will examine whether web-based CBT-I is efficacious in reducing insomnia and improving mood in caregivers of persons with dementia.
- Chronic Insomnia
- Dementia
Treatment Effectiveness
Effectiveness Progress
Study Objectives
11 Primary · 12 Secondary · Reporting Duration: 6 weeks
Trial Safety
Trial Design
1 Treatment Group
NiteCAPP: Online Cognitive Behavioral Therapy for Insomnia
1 of 1
Experimental Treatment
60 Total Participants · 1 Treatment Group
Primary Treatment: Web-based Cognitive Behavior Therapy for Insomnia (CBT-I) · No Placebo Group · N/A
Trial Logistics
Trial Timeline
Who is running the clinical trial?
Eligibility Criteria
Age 18+ · All Participants · 12 Total Inclusion Criteria
Mark “Yes” if the following statements are true for you:- Trauer, James M., Mary Y. Qian, Joseph S. Doyle, Shantha M.W. Rajaratnam, and David Cunnington. 2015. “Cognitive Behavioral Therapy for Chronic Insomnia”. Annals of Internal Medicine. American College of Physicians. doi:10.7326/m14-2841.
- McCrae, Christina S., Ashley F. Curtis, Jacob M. Williams, Natalie D. Dautovich, Joseph P.H. McNamara, Ashley Stripling, Joseph M. Dzierzewski, et al.. 2018. “Efficacy of Brief Behavioral Treatment for Insomnia in Older Adults: Examination of Sleep, Mood, and Cognitive Outcomes”. Sleep Medicine. Elsevier BV. doi:10.1016/j.sleep.2018.05.018.
- McCrae, Christina S., Rene McGovern, Robin Lukefahr, and Ashley M. Stripling. 2007. “Research Evaluating Brief Behavioral Sleep Treatments for Rural Elderly (RESTORE): A Preliminary Examination of Effectiveness”. The American Journal of Geriatric Psychiatry. Elsevier BV. doi:10.1097/jgp.0b013e31813547e6.
- Glass, Jennifer, Krista L Lanctôt, Nathan Herrmann, Beth A Sproule, and Usoa E Busto. 2005. “Sedative Hypnotics in Older People with Insomnia: Meta-analysis of Risks and Benefits”. Bmj. BMJ. doi:10.1136/bmj.38623.768588.47.
- Fonareva, Irina, Alexandra M. Amen, Daniel P. Zajdel, Roger M. Ellingson, and Barry S. Oken. 2011. “Assessing Sleep Architecture in Dementia Caregivers at Home Using an Ambulatory Polysomnographic System”. Journal of Geriatric Psychiatry and Neurology. SAGE Publications. doi:10.1177/0891988710397548.
- McCurry, Susan M., Laura E. Gibbons, Rebecca G. Logsdon, Michael V. Vitiello, and Linda Teri. 2009. “Insomnia in Caregivers of Persons with Dementia: Who Is at Risk and What Can Be Done About It?”. Sleep Medicine Clinics. Elsevier BV. doi:10.1016/j.jsmc.2009.07.005.
- Sakurai, Shihomi, Joji Onishi, and Makoto Hirai. 2014. “Impaired Autonomic Nervous System Activity During Sleep in Family Caregivers of Ambulatory Dementia Patients in Japan”. Biological Research for Nursing. SAGE Publications. doi:10.1177/1099800414524050.
- Lee, Kwo-Chen, Jia-Jean Yiin, and Yann-Fen Chao. 2016. “Effect of Integrated Caregiver Support on Caregiver Burden for People Taking Care of People with Cancer at the End of Life: A Cohort and Quasi-experimental Clinical Trial”. International Journal of Nursing Studies. Elsevier BV. doi:10.1016/j.ijnurstu.2016.01.002.
- Bédard, Michel, D. William Molloy, Larry Squire, Sacha Dubois, Judith A. Lever, and Martin O'Donnell. 2001. “The Zarit Burden Interview”. The Gerontologist. Oxford University Press (OUP). doi:10.1093/geront/41.5.652.
- McCurry, Susan M., Rebecca G. Logsdon, Linda Teri, and Michael V. Vitiello. 2007. “Sleep Disturbances in Caregivers of Persons with Dementia: Contributing Factors and Treatment Implications”. Sleep Medicine Reviews. Elsevier BV. doi:10.1016/j.smrv.2006.09.002.
- Mahoney, Diane Feeney. 2003. “Vigilance: Evolution and Definition for Caregivers of Family Members with Alzheimer's Disease”. Journal of Gerontological Nursing. SLACK, Inc.. doi:10.3928/0098-9134-20030801-07.
- GARCIA-WILLIX, DOLLY, and PATRICIA SFERRAZZA. 2010. “Research and Nursing Theory on Family Caregiving”. Home Healthcare Nurse. Ovid Technologies (Wolters Kluwer Health). doi:10.1097/nhh.0b013e3181dbf351.
- McCrae, Christina S., Joseph M. Dzierzewski, Joseph P. H. McNamara, Karlyn E. Vatthauer, Alicia J. Roth, and Meredeth A. Rowe. 2014. “Changes in Sleep Predict Changes in Affect in Older Caregivers of Individuals with Alzheimer’s Dementia: A Multilevel Model Approach: Table 1.”. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. Oxford University Press (OUP). doi:10.1093/geronb/gbu162.
- Morin, Charles M., Geneviève Belleville, Lynda Bélanger, and Hans Ivers. 2011. “The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response”. Sleep. Oxford University Press (OUP). doi:10.1093/sleep/34.5.601.
- Beaudreau, Sherry A., Adam P. Spira, Heather L. Gray, Colin A. Depp, James Long, Mark Rothkopf, and Dolores Gallagher-Thompson. 2008. “The Relationship Between Objectively Measured Sleep Disturbance and Dementia Family Caregiver Distress and Burden”. Journal of Geriatric Psychiatry and Neurology. SAGE Publications. doi:10.1177/0891988708316857.
- Creese, Joy, Michel Bédard, Kevin Brazil, and Lori Chambers. 2008. “Sleep Disturbances in Spousal Caregivers of Individuals with Alzheimer's Disease”. International Psychogeriatrics. Cambridge University Press (CUP). doi:10.1017/s1041610207005339.
- Allain, Herv??, Dani??le Bentu??-Ferrer, Elisabeth Polard, Yvette Akwa, and Alain Patat. 2005. “Postural Instability and Consequent Falls and Hip Fractures Associated with Use of Hypnotics in the Elderly”. Drugs & Aging. Springer Science and Business Media LLC. doi:10.2165/00002512-200522090-00004.
- Bertisch, Suzanne M., Shoshana J. Herzig, John W. Winkelman, and Catherine Buettner. 2014. “National Use of Prescription Medications for Insomnia: NHANES 1999-2010”. Sleep. Oxford University Press (OUP). doi:10.5665/sleep.3410.
- Crandall, Christian S., Jeanne J. Preisler, and Julie Aussprung. 1992. “Measuring Life Event Stress in the Lives of College Students: The Undergraduate Stress Questionnaire (USQ)”. Journal of Behavioral Medicine. Springer Science and Business Media LLC. doi:10.1007/bf00844860.
- Broadbent, D. E., P. F. Cooper, P. FitzGerald, and K. R. Parkes. 1982. “The Cognitive Failures Questionnaire (CFQ) and Its Correlates”. British Journal of Clinical Psychology. Wiley. doi:10.1111/j.2044-8260.1982.tb01421.x.
- McKibbin, Christine L., Sonia Ancoli-Israel, Joel Dimsdale, Christopher Archuleta, Roland von Kanel, Paul Mills, Thomas L. Patterson, and Igor Grant. 2005. “Sleep in Spousal Caregivers of People with Alzheimer's Disease”. Sleep. Oxford University Press (OUP). doi:10.1093/sleep/28.10.1245.
- McCrae, Christina S, Nancy M Wilson, Kenneth L Lichstein, H.Heith Durrence, Daniel J Taylor, Andrew J Bush, and Brant W Riedel. 2003. “‘young Old’ and ‘old Old’ Poor Sleepers with and Without Insomnia Complaints”. Journal of Psychosomatic Research. Elsevier BV. doi:10.1016/s0022-3999(02)00543-3.
- Edinger, Jack D., William K. Wohlgemuth, Andrew D. Krystal, and John R. Rice. 2005. “Behavioral Insomnia Therapy for Fibromyalgia Patients”. Archives of Internal Medicine. American Medical Association (AMA). doi:10.1001/archinte.165.21.2527.
- Pinquart, Martin, and Silvia Sörensen. 2003. “Differences Between Caregivers and Noncaregivers in Psychological Health and Physical Health: A Meta-analysis.”. Psychology and Aging. American Psychological Association (APA). doi:10.1037/0882-7974.18.2.250.
- Caswell, Lisa W., Peter P. Vitaliano, Kristin L. Croyle, James M. Scanlan, Jianping Zhang, and Anhaita Daruwala. 2003. “Negative Associations of Chronic Stress and Cognitive Performance in Older Adult Spouse Caregivers”. Experimental Aging Research. Informa UK Limited. doi:10.1080/03610730303721.
- Oken, Barry S., Irina Fonareva, and Helane Wahbeh. 2011. “Stress-related Cognitive Dysfunction in Dementia Caregivers”. Journal of Geriatric Psychiatry and Neurology. SAGE Publications. doi:10.1177/0891988711422524.
- Thomas, Philippe, Fabrice Lalloué, Pierre-Marie Preux, Cyril Hazif-Thomas, Sylvie Pariel, Robcis Inscale, Joël Belmin, and Jean-Pierre Clément. 2005. “Dementia Patients Caregivers Quality of Life: The PIXEL Study”. International Journal of Geriatric Psychiatry. Wiley. doi:10.1002/gps.1422.
- McCurry, S. M., R. G. Logsdon, M. V. Vitiello, and L. Teri. 1998. “Successful Behavioral Treatment for Reported Sleep Problems in Elderly Caregivers of Dementia Patients: A Controlled Study”. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. Oxford University Press (OUP). doi:10.1093/geronb/53b.2.p122.
- Vitaliano, Peter P., Jianping Zhang, Heather M. Young, Lisa W. Caswell, James M. Scanlan, and Diana Echeverria. 2009. “Depressed Mood Mediates Decline in Cognitive Processing Speed in Caregivers”. The Gerontologist. Oxford University Press (OUP). doi:10.1093/geront/gnp004.
- Qaseem, Amir, Devan Kansagara, Mary Ann Forciea, Molly Cooke, Thomas D. Denberg, and for the Clinical Guidelines Committee of the American College of Physicians. 2016. “Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline from the American College of Physicians”. Annals of Internal Medicine. American College of Physicians. doi:10.7326/m15-2175.
- Lichstein, Kenneth L., Nancy M. Wilson, and Christopher T. Johnson. 2000. “Psychological Treatment of Secondary Insomnia.”. Psychology and Aging. American Psychological Association (APA). doi:10.1037/0882-7974.15.2.232.
- Hasuo, Hideaki, Kenji Kanbara, Hiroko Sakuma, Kohei Yoshida, Kazuki Uchitani, and Mikihiko Fukunaga. 2019. “Self-care System for Family Caregivers of Cancer Patients Using Resonant Breathing with a Portable Home Device: A Randomized Open-label Study”. Journal of Palliative Medicine. Mary Ann Liebert Inc. doi:10.1089/jpm.2018.0230.
- Schulz, R., A. T. O'Brien, J. Bookwala, and K. Fleissner. 1995. “Psychiatric and Physical Morbidity Effects of Dementia Caregiving: Prevalence, Correlates, and Causes”. The Gerontologist. Oxford University Press (OUP). doi:10.1093/geront/35.6.771.
- Yates, M. E., S. Tennstedt, and B.-H. Chang. 1999. “Contributors to and Mediators of Psychological Well-being for Informal Caregivers”. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. Oxford University Press (OUP). doi:10.1093/geronb/54b.1.p12.
- Mackenzie, Corey S., Marilyn C. Smith, Lynn Hasher, Larry Leach, and Pearl Behl. 2007. “Cognitive Functioning Under Stress: Evidence from Informal Caregivers of Palliative Patients”. Journal of Palliative Medicine. Mary Ann Liebert Inc. doi:10.1089/jpm.2006.0171.
- Joan S. Grant, Alfred A. Bartolucci. 2000. “Sociodemographic, Physical, and Psychosocial Characteristics of Depressed and Non-depressed Family Caregivers of Stroke Survivors”. Brain Injury. Informa UK Limited. doi:10.1080/02699050050203586.
- Edinger, Jack D., William K. Wohlgemuth, Andrew D. Krystal, and John R. Rice. 2005. “Behavioral Insomnia Therapy for Fibromyalgia Patients”. Archives of Internal Medicine. American Medical Association (AMA). doi:10.1001/archinte.165.21.2527.
- Lichstein KL, Riedel BW, Grieve R. Fair tests of clinical trials: A treatment implementation model. Advances in Behaviour Research and Therapy. 1994;16(1):1-29.
- McCrae, Christina S., Ashley F. Curtis, Jacob M. Williams, Natalie D. Dautovich, Joseph P.H. McNamara, Ashley Stripling, Joseph M. Dzierzewski, et al.. 2018. “Efficacy of Brief Behavioral Treatment for Insomnia in Older Adults: Examination of Sleep, Mood, and Cognitive Outcomes”. Sleep Medicine. Elsevier BV. doi:10.1016/j.sleep.2018.05.018.
- Astell A, Alm N, Gowans G, Ellis M, Dye R, Vaughan P. Involving older people with dementia and their carers in designing computer based support systems: some methodological considerations. Universal Access in the Information Society. 2009;8(1):49.
- Hopkins R, Kilik L. Kingston Caregiver Stress Scale administration and interpretation manual. Kingston, Canada: Geriatric Psychiatry Programme, Providence Care, Mental...; 2012.
- Slotkin J, Kallen M, Griffith J, et al. NIH toolbox technical manual. Bethesda, MD: National Institutes of Health. 2012.
- Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. State-Trait Anxiety Inventory, Form Y.Palo Alto, CA: Consulting Psychologists Press; 1983.
- Morin CM. Insomnia: Psychological assessment and management.Guilford Press; 1993.
- Nezu AM, Nezu CM, Perri MG. Psychotherapy for adults within a problem-solving framework: Focus on depression. J Cogn Psychother. 1990;4(3):247-256.
- McCrae CS, Tierney CG, McNamara JP. Behavioral Intervention for Insomnia: Future Directions for Nontraditional Caregivers at Various Stages of Care. Clinical Geropsychologist. 2005;29(2):95-115.
- McCrae CS, Tierney CG, McNamara JP. Behavioral intervention for insomnia: Future directions for nontraditional caregivers at various stages of care. Clinical gerontologist. 2006;29(2):95-114.
- GARCIA-WILLIX, DOLLY, and PATRICIA SFERRAZZA. 2010. “Research and Nursing Theory on Family Caregiving”. Home Healthcare Nurse. Ovid Technologies (Wolters Kluwer Health). doi:10.1097/nhh.0b013e3181dbf351.
- Beck AT, Steer RA, Garbin MG. Beck Depression Inventory-Second Edition.San Antonio, TX: The Psychological Corporation; 1996.
- McCrae, Christina S., Rene McGovern, Robin Lukefahr, and Ashley M. Stripling. 2007. “Research Evaluating Brief Behavioral Sleep Treatments for Rural Elderly (RESTORE): A Preliminary Examination of Effectiveness”. The American Journal of Geriatric Psychiatry. Elsevier BV. doi:10.1097/jgp.0b013e31813547e6.
- Broadbent, D. E., P. F. Cooper, P. FitzGerald, and K. R. Parkes. 1982. “The Cognitive Failures Questionnaire (CFQ) and Its Correlates”. British Journal of Clinical Psychology. Wiley. doi:10.1111/j.2044-8260.1982.tb01421.x.
- Bedard M, Molloy DW, Squire L, Dubois S, Lever JA, O'Donnell M. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001 Oct;41(5):652-7. doi: 10.1093/geront/41.5.652.
- Schulz R, O'Brien AT, Bookwala J, Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist. 1995 Dec;35(6):771-91. doi: 10.1093/geront/35.6.771.
- Mackenzie CS, Smith MC, Hasher L, Leach L, Behl P. Cognitive functioning under stress: evidence from informal caregivers of palliative patients. J Palliat Med. 2007 Jun;10(3):749-58. doi: 10.1089/jpm.2006.0171.
- Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial. Arch Intern Med. 2005 Nov 28;165(21):2527-35. doi: 10.1001/archinte.165.21.2527.
- Glass J, Lanctot KL, Herrmann N, Sproule BA, Busto UE. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ. 2005 Nov 19;331(7526):1169. doi: 10.1136/bmj.38623.768588.47. Epub 2005 Nov 11.
- Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011 May 1;34(5):601-8. doi: 10.1093/sleep/34.5.601.
- Pinquart M, Sorensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging. 2003 Jun;18(2):250-67. doi: 10.1037/0882-7974.18.2.250.
- McCrae CS, McGovern R, Lukefahr R, Stripling AM. Research Evaluating Brief Behavioral Sleep Treatments for Rural Elderly (RESTORE): a preliminary examination of effectiveness. Am J Geriatr Psychiatry. 2007 Nov;15(11):979-82. doi: 10.1097/JGP.0b013e31813547e6.
- McCurry SM, Logsdon RG, Vitiello MV, Teri L. Successful behavioral treatment for reported sleep problems in elderly caregivers of dementia patients: a controlled study. J Gerontol B Psychol Sci Soc Sci. 1998 Mar;53(2):P122-9. doi: 10.1093/geronb/53b.2.p122.
- Caswell LW, Vitaliano PP, Croyle KL, Scanlan JM, Zhang J, Daruwala A. Negative associations of chronic stress and cognitive performance in older adult spouse caregivers. Exp Aging Res. 2003 Jul-Sep;29(3):303-18. doi: 10.1080/03610730303721.
- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.
- Creese J, Bedard M, Brazil K, Chambers L. Sleep disturbances in spousal caregivers of individuals with Alzheimer's disease. Int Psychogeriatr. 2008 Feb;20(1):149-61. doi: 10.1017/S1041610207005339. Epub 2007 Apr 30.
- Schulz R, Martire LM. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. Am J Geriatr Psychiatry. 2004 May-Jun;12(3):240-9.
- Allain H, Bentue-Ferrer D, Polard E, Akwa Y, Patat A. Postural instability and consequent falls and hip fractures associated with use of hypnotics in the elderly: a comparative review. Drugs Aging. 2005;22(9):749-65. doi: 10.2165/00002512-200522090-00004.
- Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Aug 4;163(3):191-204. doi: 10.7326/M14-2841.
- McCurry SM, Gibbons LE, Logsdon RG, Vitiello MV, Teri L. Insomnia In Caregivers Of Persons With Dementia: Who Is At Risk And What Can Be Done About It? Sleep Med Clin. 2009 Dec 1;4(4):519-526. doi: 10.1016/j.jsmc.2009.07.005.
- Thomas P, Lalloue F, Preux PM, Hazif-Thomas C, Pariel S, Inscale R, Belmin J, Clement JP. Dementia patients caregivers quality of life: the PIXEL study. Int J Geriatr Psychiatry. 2006 Jan;21(1):50-6. doi: 10.1002/gps.1422.
- McCurry SM, Logsdon RG, Teri L, Vitiello MV. Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. Sleep Med Rev. 2007 Apr;11(2):143-53. doi: 10.1016/j.smrv.2006.09.002. Epub 2007 Feb 6.
- McCrae CS, Wilson NM, Lichstein KL, Durrence HH, Taylor DJ, Bush AJ, Riedel BW. 'Young old' and 'old old' poor sleepers with and without insomnia complaints. J Psychosom Res. 2003 Jan;54(1):11-9. doi: 10.1016/s0022-3999(02)00543-3.
- Mahoney DF. Vigilance. Evolution and definition for caregivers of family members with Alzheimer's disease. J Gerontol Nurs. 2003 Aug;29(8):24-30. doi: 10.3928/0098-9134-20030801-07.
- Grant JS, Bartolucci AA, Elliot TR, Giger JN. Sociodemographic, physical, and psychosocial characteristics of depressed and non-depressed family caregivers of stroke survivors. Brain Inj. 2000 Dec;14(12):1089-100. doi: 10.1080/02699050050203586.
- Yates ME, Tennstedt S, Chang BH. Contributors to and mediators of psychological well-being for informal caregivers. J Gerontol B Psychol Sci Soc Sci. 1999 Jan;54(1):P12-22. doi: 10.1093/geronb/54b.1.p12.
- Lichstein KL, Wilson NM, Johnson CT. Psychological treatment of secondary insomnia. Psychol Aging. 2000 Jun;15(2):232-40. doi: 10.1037//0882-7974.15.2.232.
- Christina McCrae 2022. "Web-based Cognitive Behavioral Treatment for Insomnia in Dementia Caregivers". ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT04632628.
Frequently Asked Questions
Does this clinical experiment have open vacancies for participants?
"According to clinicaltrials.gov, this scientific investigation is actively recruiting participants since its inception on January 1st 2022 and most recently modified April 26th 2021." - Anonymous Online Contributor
What is the desired outcome of this investigation?
"This 6-week trial aims to assess Objective Daily Sleep Actiwatch-2 - Sleep Efficiency as its primary objective. As secondary objectives, the study looks at three other metrics: Beck Depression Inventory Second Edition (BDI-II), Perceived Stress Scale (PSS) and Kingston Caregiver Stress Scale. The BDI II measures depressive symptoms on a scale of 0 to 63; the PSS gauges perceived stress from 0 to 40, while the KCSS evaluates caregiver stress from 10 to 50 with higher scores correlating with greater levels of both depression and stress." - Anonymous Online Contributor
How many test subjects are currently enrolled in this experiment?
"Indeed, the clinicaltrials.gov website affirms that this medical trial is currently recruiting participants; it was initially published on January 1st 2022 and edited most recently April 26th 2021. The investigation requires 60 subjects to be enrolled at a single site." - Anonymous Online Contributor