(PS8-1) An Open Trial Integrating Memory Support into the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) to Improve Sleep and Psychological Wellness Outcomes

Abstract Text: Older and midlife adults commonly experience sleep problems, which are associated with deteriorating health and quality of life. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) is a psychosocial treatment designed to target a range of sleep and circadian problems. Midlife and older adults may be particularly affected by poor memory for such treatments, as memory functioning declines as we age. Poor memory for treatment has been associated with reduced adherence to treatment and poorer outcomes. This open trial integrated the Memory Support Intervention (MSI) and boosters into TranS-C to enhance memory for treatment and improving outcomes. The MSI consists of four constructive and four non-constructive memory support strategies. Meanwhile, boosters refer to a variety of post-treatment interventions that remind participants of treatment content and help patients troubleshoot obstacles in applying treatment recommendations, ranging from minimal contact to full engagement with the therapist. The first aim was to evaluate the effect of TranS-C + MSI on psychological wellness outcomes, including positive and negative affect, satisfaction with life, perceived stress, and fatigue. The second aim was to characterize booster preference and delivery method. The third aim was to evaluate the effect of boosters on sleep outcomes, including sleep-related impairment, sleep disturbance, sleep-related habit strength, and TranS-C skill utilization.

Participants (N = 26), aged 55 years and older (M = 72.17, SD = 6.472) with sleep or circadian problems, were recruited from the community. Participants underwent two to nine sessions of TranS-C + MSI and completed a pre-treatment and post-treatment assessment, which evaluated sleep and psychological wellness outcomes. Following the completion of treatment, participants were asked if they would like to participate in optional boosters via email, text, or snail mail. Participants who opted to receive boosters completed a pre-booster and post-booster assessment, which measured sleep outcomes.

TranS-C + MSI had a small, non-significant effect on positive affect (t(23) = -1.34, p = 0.19, d = -0.25), such that TranS-C + MSI was associated with an improvement in positive affect. There were no other effects across any of the other psychological wellness outcomes. Sixteen participants expressed interest in receiving boosters and selected their preferred delivery method as either text (n = 9), email (n= 15), or snail mail (n = 9). Participants demonstrated significant improvements in sleep-related impairment (t(14) = 3.13, p = 0.007, d = 0.58) from pre- to post-booster. Boosters had also a small effect that approached significance on TranS-C skill utilization (t(14) = -1.95, p = 0.07, d = -0.19) and a small effect on sleep-related habits (t(14) = -1.10, p = 0.29, d = -0.24), but no significant effect on sleep disturbance.

This open trial has provided preliminary findings regarding the effectiveness of TranS-C + MSI in improving psychological wellness. Furthermore, most participants expressed interest in receiving boosters and booster delivery demonstrated promise in enhancing certain sleep outcomes, warranting further investigation in future studies.