Lead project ‘elderly & wellbeing’
The objective of the study “Brief Interventions for Sleep in Elderly Patients" (BISleEP)” carried out in the framework of the main theme of the Brugmann Foundation is to study the sleep of elderly hospitalized patients via polysomnography and self-questionnaires and to observe the effects of non-pharmacological treatment on sleep in this population.
Sleep undergoes changes throughout life. With age, these modifications are manifested by a polyphasic tendency (sleep that takes place at several times during the day) and a decrease in deep slow wave and REM sleep as well as a greater fragmentation of sleep (characterized by frequent awakenings during the night). In addition to these natural age-related changes, hospitalization conditions further alter this sleep by further weakening its continuity and decreasing (or even eliminating) the amount of deep slow wave and REM sleep. Indeed, these hospitalization conditions are very often characterized by an immobilization of the patient which decreases the sleep pressure which causes in particular a longer latency of falling asleep. Also, the use of hypnotics during hospitalization is associated with a cognitive decline that can also alter sleep.
Polysomnography is the most widely recognized medical technique in sleep analysis today. It is a medical examination that records several physiological variables simultaneously, such as brain activity, eye movements, heart rate, respiratory and muscular activity. The recording of these different components makes it possible to analyze sleep according to objective criteria and thus to obtain data characterizing sleep such as total sleep time, time spent in the different sleep stages (awake phases, light slow wave sleep, deep sleep and REM sleep…). It is also the polysomnography and its interpretation that enable diagnoses to be made of the various sleep disorders (sleep apnea syndrome, REM sleep behavior disorder, insomnia, narcolepsy…).
The non-pharmacological management proposed during this study is a therapeutic behavioral and psycho-educational intervention inspired by cognitive behavioral therapy for insomnia (CBTi). CBTi is commonly used in this context and its effects are recognized by the scientific community. Overall, the aim is to reduce certain behaviors that can be detrimental to sleep (such as going to bed often too early, not adapted to the patient's homeostatic needs, caffeine consumption and napping after 5 p.m…).
Few studies have currently focused on the objective analysis of sleep via polysomnography of elderly hospitalized patients combined with behavioral management of this sleep within the hospitalization. It is also recognized that sleep disorders in this population are frequent and that the conditions of hospitalization can be detrimental to sleep. These different arguments are the motivating factors for this study.
The present study was designed in collaboration with Dr. Sophie Levy, Physician in complementary training in Geriatrics, Geriatric Service of the Brugmann University Hospital, and Mr. Maxime Windal, MPsy, under the supervision of Prof. dr. C. Kornreich, O. Mairesse, M. Surquin and F. Benoit. Mr. Windal is currently funded by the Brugmann Foundation until the end of 2021. We are looking for an additional 1-2 years of support for a research mandate at 1 full time equivalent until the end of the project.