Assessment of sleep and cognition and the feasibility of digital sleep-promotion in the PROTECT Norge cohort

Abstract

As the global population ages, insomnia is expected to become increasingly prevalent. Access to non-pharmacological treatments, such as cognitive behavioural therapy, remains limited, creating an unmet need for both prevention and treatment options. Poor sleep negatively impacts quality of life and health, and emerging evidence links sleep disturbances to cognitive decline and an increased risk of dementia. PROTECT, an online longitudinal study and research infrastructure running in several countries, leverages the widespread use of digital technology to address cognitive health. Using a multi-method approach, this work builds on the PROTECT infrastructures in the UK and Norway. It utilises data from the PROTECT UK cohort exploring how sleep duration and fragmentation affect cognitive function, adjusting for potential modifiable risk factors for dementia. Then, facilitated by the PROTECT Norge infrastructure, it focuses on the development and evaluation of the feasibility of the eHealth intervention ASLEEP, a digital adaptation of a self-help book for insomnia, designed for individuals aged 50 and above. Employing univariate regression analyses, both short and long sleep durations, as well as fragmented sleep, were found to associate with poorer cognitive outcomes in memory and reasoning domains. Systematic text condensation on focus group data from the feasibility study revealed that ASLEEP was acceptable for individuals aged 50 and above, with psychoeducation delivered through videos and self-monitoring tools via a sleep diary being particularly beneficial for increasing knowledge and awareness about sleep. However, digital insecurities, stemming from unfamiliarity with the technology and app instability were noted, even though mitigated by the availability of technical support. The findings suggest that promoting sleep through eHealth interventions for individuals aged 50 is both feasible and acceptable. The quantitative findings indicate that maintaining normal sleep patterns may support cognitive health in ageing. Further research is warranted to assess whether insomnia treatment can improve cognition.