Effect of Activities and Exercise on Sleep in Dementia

活动和锻炼对痴呆症患者睡眠的影响

• 批准号: 6745588
• 负责人: Kathy Culpepper Richards
• 金额: $ 44.02万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-08-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6745588
• 关键词: actigraphy; aging; behavior test; behavioral /social science research tag; body physical activity; circadian rhythms; clinical research; cognition disorders; dementia; exercise; human subject; human therapy evaluation; muscle strength; musics; nursing homes; patient oriented research; play; polysomnography; sleep; sleep disorders; social behavior

DESCRIPTION (provided by applicant): Sleep disturbance is a highly prevalent, disabling symptom in persons with cognitive impairment, particularly those in nursing homes. Their nocturnal sleep is light and fragmented with frequent awakenings. Persistent short napping episodes interfere with daytime functioning and nighttime sleep. Current interventions for sleep disturbance consist primarily of pharmacologic agents, but they have proven only minimally effective and have serious side effects. Feasible, cost-effective behavioral interventions that address the precipitating causes of disturbed sleep, such as daytime napping and reduced social and physical activity, are needed. Thus, the primary specific aim for this randomized controlled trial is to determine the effect of individualized social activity, progressive resistance training, combined individualized social activity and progressive resistance training, or a usual care control condition on nocturnal total sleep time and amplitude of the sleep-wake rhythm in nursing home residents with cognitive impairment. The secondary specific aim is to explore the roles of daytime napping, muscle strength, and physical activity in mediating the effect of progressive resistance training on nocturnal total sleep time. A total of 304 nursing home residents with cognitive impairment will be randomly assigned to receive individualized social activity such as games or music, high intensity progressive resistance training of the hip and arm extensors, combined social activity and progressive resistance training, or a usual care control condition for seven weeks. Polysomnography, actigraphy, direct observation, and one-repetition maximum testing will be used to measure the study outcomes at baseline and during week seven. The study follows a 2x2 factorial design, and will be analyzed using ANOVA with separate analyses for the two primary outcome variables of change in nocturnal total sleep time and amplitude of the sleep-wake rhythm. Path analysis will be used to explore the roles of daytime napping, muscle strength, and physical activity in mediating the effect of progressive resistance training on nocturnal total sleep time. This study will provide important new prescriptive data for clinicians on the usefulness of limiting daytime napping and promoting social and physical activity in elders with cognitive impairment and disturbed sleep.

描述（由申请人提供）：睡眠障碍是认知障碍患者（尤其是疗养院患者）中一种非常普遍的致残症状。他们的夜间睡眠很浅且不连续，并且经常醒来。持续的短时间小睡会干扰白天的功能和夜间的睡眠。目前针对睡眠障碍的干预措施主要包括药物，但事实证明它们的效果甚微，并且具有严重的副作用。需要采取可行的、具有成本效益的行为干预措施来解决睡眠障碍的诱因，例如白天小睡和减少社交和身体活动。因此，这项随机对照试验的主要具体目的是确定个体化社交活动、渐进性阻力训练、个体化社交活动和渐进性阻力训练相结合或常规护理控制条件对夜间总睡眠时间和睡眠幅度的影响-患有认知障碍的疗养院居民的觉醒节律。第二个具体目标是探索白天小睡、肌肉力量和体力活动在调节渐进性阻力训练对夜间总睡眠时间影响中的作用。共有 304 名患有认知障碍的疗养院居民将被随机分配接受个性化的社交活动，例如游戏或音乐、髋部和手臂伸肌的高强度渐进式阻力训练、社交活动和渐进式阻力训练相结合，或常规护理控制状态持续七周。将使用多导睡眠图、体动记录仪、直接观察和单次最大测试来衡量基线和第七周的研究结果。该研究遵循 2x2 因子设计，并将使用方差分析对夜间总睡眠时间和睡眠-觉醒节律幅度变化的两个主要结果变量进行单独分析。路径分析将用于探索白天小睡、肌肉力量和体力活动在调节渐进性阻力训练对夜间总睡眠时间影响中的作用。这项研究将为临床医生提供重要的新的规范性数据，以了解限制白天小睡和促进患有认知障碍和睡眠障碍的老年人的社交和身体活动的有效性。