ABSTRACT
BACKGROUND: Challenges to integrating health promotion including sleep health into entry-level physical therapist curricula include lack of faculty expertise, time, and support. A lecture provided by a content expert may mitigate such challenges. The purpose of this study was to determine if a sleep education session impacts Doctor of Physical Therapy students' knowledge and beliefs about sleep. METHODS: Faculty shared the opportunity to participate in the study 1-3 days prior to the remotely-provided lecture including sleep health assessment and interventions. The survey included demographics, a sleep health knowledge question, 11 questions on "What I think about sleep as a professional", and the 20-item Sleep Beliefs Scale. McNemar's and paired sample t-tests determined change in knowledge and beliefs. RESULTS: 209 individuals (70% female, 86% Caucasian, 25.5 ± 3.4 years old) completed the pre-lecture survey, and 137 individuals completed the post-lecture survey. There was an increase in knowledge about sleep health (p < .001) and change in Sleep Beliefs Scales score (p < .001). CONCLUSIONS: A single remotely provided sleep education session increased DPT students' knowledge and changed their beliefs about sleep. Future studies should determine if these positive beliefs about sleep translate into clinical practice and enhance patient outcomes.
Subject(s)
Curriculum , Students , Female , Humans , Young Adult , Adult , Male , Educational Status , Physical Therapy Modalities , SleepABSTRACT
AIMS: While challenges and barriers to incorporating health promotion into physical therapist (PT) practice have been previously described, none have specifically assessed the challenges and barriers to incorporating sleep health into PT practice. The objective of this study was to elucidate the perceived barriers and facilitators of incorporating sleep health into outpatient PT practice. METHODS: An electronic survey was developed via qualitative interview and expert feedback. Invitation to participate was posted on two professional organization's discussion boards and sent via email to alumni, clinical instructors, and PT colleagues. Descriptive analyses were conducted. RESULTS: 128 individuals (72% female, age 39.6 ± 10.3 years) completed the survey. The top three barriers were: "Patient's low motivation to change their sleep behavior" (87%), and "Lack of sleep assessment resources" and "Lack of sleep intervention resources" (both 82%). The top three facilitators were: "Growing knowledge of importance of sleep in PT practice" (86%), "Shift in PT practice to emphasis on health promotion and wellness" (84%), and "Shift in PT practice to person-centered focus" (80%). CONCLUSION: Understanding factors contributing to the "knowledge-to-action" sleep health gap in PT practice will aid in the development of strategies to mitigate the barriers and strengthen the facilitators.
Subject(s)
Physical Therapists , Humans , Female , Adult , Middle Aged , Male , Outpatients , Health Promotion , Sleep , Qualitative ResearchABSTRACT
Background: Over 50% of individuals with multiple sclerosis (MS) have moderate or severe sleep disturbances, insomnia being the most common. In-person cognitive behavioral therapy for insomnia (F2F-CBTi) is currently the first-line treatment for insomnia. However, given potential limitations to access including mobility difficulty, fatigue, or living in a rural area, telehealth-delivered CBT-I (tele-CBTi) has been considered as an alternative treatment. The purpose of this study was to assess the feasibility and treatment effect of tele-CBTi in people with MS and compare it to outcomes from a F2F-CBTi study in individuals with MS. Methods: 11 individuals with MS and symptoms of insomnia participated in 6 weekly CBT-I sessions with a trained CBT-I provider via live video. Insomnia severity (ISI), sleep quality (PSQI), and fatigue severity (FSS and MFIS) were assessed pre- and posttreatment as primary outcomes. Sleep onset latency (SOL), sleep efficiency (SE) and total sleep time (TST) from the PSQI, depression (PHQ-9), anxiety (GAD-7), sleep self-efficacy (SSES), and quality of life (MSIS-29) were also assessed pre- and posttreatment as secondary outcomes. Results: Participants resided in 9 different states. Retention and adherence rates were 100%. There were significant improvements in ISI, PSQI, MFIS, FSS, SOL, SSES, PHQ-9, and MSIS-29, but not SE, TST, or GAD-7. There were no significant differences between the F2F-CBTi group and tele-CBTi group for magnitude of change in the primary outcomes (ISI, PSQI, MFIS, and FSS) or the secondary outcomes (SOL, SE, TST, SSES, PHQ-9, GAD-7, and MSIS-29). Conclusions: Tele-CBTi is feasible and has outcome measures that are similar to that of in-person CBT-I treatment. Tele-CBTi may increase access to insomnia treatment in individuals with MS.
ABSTRACT
Lifestyle interventions to increase exercise and improve diet have been the focus of recent clinical trials to potentially prevent Alzheimer's disease (AD). However, despite the strong links between sleep disruptions, cognitive decline, and AD, sleep enhancement has yet to be targeted as a lifestyle intervention to prevent AD. A recent meta-analysis suggests that approximately 15% of AD may be prevented by an efficacious intervention aimed to reduce sleep disturbances and sleep disorders. Chronic insomnia is the most frequent sleep disorder occurring in at least 40% of older adults. Individuals with insomnia are more likely to be diagnosed with Alzheimer's Disease (AD) and demonstrate decline in cognitive function at long-term follow-up. AD is characterized by the accumulation of amyloid-ß (Aß) plaques and tau tangles in the brain, and growing evidence shows impaired sleep contributes to the accumulation of Aß. An intervention aimed at improving insomnia may be a critical opportunity for primary prevention to slow cognitive decline and potentially delay the onset of AD. Cognitive behavioral therapy for insomnia (CBT-I) is an efficacious treatment for insomnia, but the use of CBT-I to improve cognitive function and potentially reduce the rate of Aß accumulation has never been examined. Therefore, the objective of the proposed study is to examine the efficacy of CBT-I on improving cognitive function in older adults with symptoms of insomnia. An exploratory aim is to assess the effect of CBT-I on rate of Aß accumulation.
