Aging: Insomnia Treatment and Energy Balance

衰老：失眠治疗和能量平衡

• 批准号: 7917204
• 负责人: SAROSH J MOTIVALA
• 金额: $ 12.18万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7917204
• 关键词: Address; Aftercare; Age; Aging; Ancillary Study; Area; Behavior Therapy; Behavioral; Biological; Biological Factors; Blood specimen; Body mass index; Brain; Chronic Insomnia; Clinical; Clinical Data; Clinical Research; Clinical Trials; Cognitive Therapy; Communities; Desire for food; Diagnostic; Disease Outcome; Distress; Education; Elderly; Epidemiologic Studies; Funding; Geriatrics; Health; Health education; Hormones; Hunger; Hygiene; Impairment; Intervention; Intervention Trial; Investigation; Lead; Leptin; Link; Lipids; Literature; Maintenance; Measures; Mentors; Obesity; Outcome; Outcome Assessment; Outcome Study; Outcomes Research; Parents; Patient Self-Report; Patients; Pharmaceutical Preparations; Play; Polysomnography; Population; Prevalence; Psychologist; Psychophysiology; Randomized Controlled Trials; Regulation; Reporting; Research; Research Personnel; Role; Satiation; Scientist; Signal Transduction; Sleep; Sleep Disorders; Sleeplessness; Symptoms; Tai Ji; Testing; Therapeutic Effect; Time; Training; Treatment outcome; Uncertainty; Validation; Weight Gain; Work; awake; biological research; cost; cytokine; energy balance; ghrelin; heart rate variability; human old age (65+); hypnotic; improved; mortality; parent project; programs; treatment effect; treatment trial; trial comparing

DESCRIPTION (provided by applicant): Over 50% of adults older than 65 years report problems sleeping and the prevalence of persistent insomnia is estimated to be over 30% in this population, and steadily increases with age. Behavioral treatments for chronic insomnia have demonstrated consistent improvements in self-reported sleep, but outcome assessment, including polysomnography, behavioral factors such as health functioning and biologic factors impacted by sleep have not been comprehensively examined, especially in older adults. In particular, one promising area of research is the impact of interventions on energy balance. The hormones ghrelin and leptin are thought to convey information about energy balance to the brain, and dysregulation of these hormones lead to increases in appetite and lipid accumulation. Epidemiologic studies have found that poor sleep is associated with elevated ghrelin and decreased leptin, corroborated by experimental sleep restriction studies as well. Elevated ghrelin and decreased leptin levels also correlate with increased sympathetic activity; which is seen in insomnia patients. Taken together, these findings indicate that older insomnia patients may have altered energy balance. Yet few studies have measured objective sleep assessment following insomnia interventions and no study has reported its effects on energy balance. The proposed project is an ancillary study to a newly funded NIA randomized, controlled trial comparing the effects of cognitive-behavioral therapy (CBT), Tai Chi Chih (TCC), and hygiene/education control (EC) on sleep outcomes in older insomnia patients. This K23 project is an opportunity for the PI (a health-clinical psychologist) to utilize expertise in sleep and psychophysiology assessment and previous clinical training while developing expertise in behavioral insomnia treatment research and biological effects of treatment. The unique aims of this K23 project are to: 1) evaluate the effects of CBT vs. TCC vs. EC on ghrelin and leptin levels at baseline, mid- treatment, post-treatment and 3- and 12-month follow-ups; 2) determine the effects of CBT vs. TCC vs. EC on nocturnal autonomic function (power spectral analysis of heart rate variability) during sleep assessments at the UCLA GCRC at baseline and post-treatment; 3) examine whether energy balance and autonomic function are related to improvements in objective and subjective measures of sleep over the course of the treatment trial.

描述（由申请人提供）：超过50％的65岁以上的成年人报告睡眠问题，持续失眠的患病率估计在该人群中超过30％，并且随着年龄的增长而稳步增加。慢性失眠症的行为治疗表明，自我报告的睡眠中已经有一致的改善，但是尚未全面检查成果评估，包括多个多摄影术，诸如健康功能的行为因素和诸如健康功能和生物学因素之类的行为因素，尚未得到全面检查，尤其是在老年人中。特别是，研究的一个有希望的领域是干预措施对能量平衡的影响。人们认为，激素和瘦素可以将有关能量平衡的信息传达给大脑，这些激素的失调导致食欲和脂质积累的增加。流行病学研究发现，睡眠不良与升高的血肽蛋白升高和瘦素降低有关，这也通过实验性睡眠限制研究证实。升高的生长素和瘦素水平降低也与交感神经的增加相关。在失眠症患者中可以看到。综上所述，这些发现表明老年失眠患者可能改变了能量平衡。然而，在失眠干预后，很少有研究衡量客观睡眠评估，并且没有任何研究报告其对能量平衡的影响。拟议的项目是一项辅助研究，对新资助的NIA随机，对照试验进行了比较，比较了认知行为疗法（CBT），TAI CHI CHIH（TCC）和卫生/教育控制（EC）对老年失眠症患者睡眠成果的影响。这个K23项目是PI（一名卫生心理学家）在睡眠和心理生理学评估和以前的临床培训方面利用专业知识的机会，同时开发了行为失眠治疗研究和治疗的生物学效应方面的专业知识。该K23项目的独特目的是：1）评估CBT与TCC与EC对生长素蛋白和瘦素水平的影响，基线，中期治疗，治疗后以及3个月和12个月的随访； 2）确定CBT与TCC与EC对夜间自主函数的影响（对心率变异性的功率谱分析）在基线和处理后的UCLA GCRC的睡眠评估期间的影响； 3）检查能量平衡和自主功能是否与治疗试验过程中的客观和主观衡量标准的改善有关。