Behavioral treatment improves sleep in veterans

Behavioral insomnia therapy combined with a positive airway pressure adherence program may improve sleep in adults with coexisting obstructive sleep apnea and insomnia, according to findings presented at the American Geriatrics Society Annual Scientific Meeting.

“Obstructive sleep apnea is common in older adults and often presents with coexisting insomnia,” Cathy Alessi, MD, professor of geriatric medicine and acting director of the Geriatric Research, Education and Clinical Center at VA Greater Los Angeles Healthcare System, and colleagues wrote in an abstract. “Insomnia predicts worse adherence with [obstructive sleep apnea] treatment by positive airway pressure.”

With the goal of improving sleep and positive airway pressure adherence in veterans with both conditions, researchers conducted a 4-year, randomized controlled trial in which they tested a new treatment that combined behavioral insomnia therapy with a positive airway pressure adherence program. Researchers enrolled 125 veterans aged 50 years or older (mean age 63; 96% male; 42% non-Hispanic white) with obstructive sleep apnea and chronic insomnia. Researchers randomly assigned participants to either a treatment group that included five weekly sessions of behavioral insomnia therapy integrated with a positive airway pressure adherence program or a control group. The control consisted of general sleep education. Researchers measured sleep onset latency, wake after sleep onset, and sleep efficiency at 3 months and 6 months.

Researchers found that participants in the treatment group had greater improvements in all sleep criteria, as well as in positive airway pressure adherence.

“This novel intervention improves sleep and [positive airway pressure] adherence in veterans with coexisting [obstructive sleep apnea] and insomnia, with similar gains in older versus middle-aged adults,” the researchers wrote. – by Melissa J. Webb

Reference:

Alessi C, et al. Randomized controlled trial of behavioral treatment for coexisting insomnia and obstructive sleep apnea: Results in middle-aged versus older adults. Presented at: American Geriatrics Society Annual Scientific Meeting; May 3-5, 2018; Orlando, Florida.

Disclosures: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.