Bedtime: A Boon for the Aging Brain?

Could teaching individuals with mild cognitive decline how to sleep better actually stave off their descent into dementia?

That’s Meghan Mattos’ focus. And with support from a $300,000 Translational Health Research Institute grant, Mattos – an assistant professor of nursing at the University of Virginia who’s studied rural-dwelling adults with mild cognitive impairment – will determine the feasibility of an online sleep education program developed by UVA psychology professor Lee Ritterband in older adults with this early form of dementia.

The hypothesis, Mattos explained, is not only that the six-week program may offer non-pharmacological insomnia relief to patients with mild cognitive impairment, but that purposefully improving their sleep patterns through an accessible online program may slow their otherwise likely decline towards dementia.

“We don’t know if bad sleep is causing dementia, or dementia is causing bad sleep,” Mattos said, “but we do know that there’s a relationship between them, and we hope to find out what is causing what” – and what difference a program like Ritterband’s SHUTi OASIS (Sleep Healthy Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness) might make.

Meghan Mattos, on assistant professor of nursing, won a $300,000 Translational Health Research Institute grant to study an online intervention that promotes better sleep patterns in the elderly. (Photo by Christine Phelan Kueter, UVA Nursing)

Recruiting subjects age 55 and older from UVA’s Memory and Aging Care Clinic, Mattos will enroll individuals diagnosed with mild cognitive impairment and insomnia who, over six weeks, will use the SHUTi OASIS program, an interactive, tailored, web-based intervention that can be completed from the comfort of one’s home. Wristwatch-like actigraphs capture minute details about subjects’ sleep and wake patterns – data that, with subjects’ pre- and post-intervention sleep diaries and interviews, will enable Mattos to assess sleep and cognitive change over time.

While earlier versions of SHUTi have been tested and validated, this newer version – which is being evaluated as part of a National Institutes of Health grant – has been optimized for adults 55 and older through the use of more senior actors and with the inclusion of topics more relevant to this population, such as pain and nocturia (the need to wake up several times each night to urinate).

Older adults with mild cognitive impairment, who are significantly more likely to develop Alzheimer’s and other types of dementia, are familiar terrain for Mattos. With the sizable proportion of older adults who suffer from insomnia – roughly one-third of older Americans – “we’re looking at something that’s an issue for a large part” of the population, Mattos said.

Currently, there’s no known cure for mild cognitive impairment. Current treatments focus on maintenance of cognitive function and management of behavioral symptoms to slow or delay disease symptoms.

“Targeting this at-risk group is important because there’s no drug, and no way to ward off time to progression to Alzheimer’s and other dementias,” Mattos said. “So if this intervention improves these patients’ quality of life, and lengthens the span of a patient’s functional ability, and joy in life – well, that’s why we want to do this.”