{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:36:20Z","timestamp":1785418580869,"version":"3.56.0"},"reference-count":77,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["DTICTN-2021-003"],"award-info":[{"award-number":["DTICTN-2021-003"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]},{"award":["DTICTN-2021-003"],"award-info":[{"award-number":["DTICTN-2021-003"]}],"id":[{"id":"https:\/\/ror.org\/003hb2249","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Dementia is a leading and growing cause of disability worldwide. Insomnia is highly prevalent in mild cognitive impairment (MCI) and dementia and is associated with impaired cognition, functional decline, and reduced quality of life (QoL). Although sleep disturbance represents a potentially modifiable risk factor within the trajectory of cognitive impairment, there have not been many studies conducted to examine the feasibility or preliminary efficacy of digital cognitive behavioural therapy for insomnia (dCBT-I) in this population. The aim of this pilot randomised controlled feasibility study is to evaluate the acceptability, adherence, and potential clinical effects of a multi-component dCBT-I programme (Sleepio) in adults with MCI or mild dementia and comorbid insomnia. Thirty community-dwelling adults aged \u226550 years with established MCI or mild dementia (Mini-Mental State Examination \u226518; Clinical Dementia Rating 0.5\u20131.0) and insomnia (Sleep Condition Indicator \u226416) will be randomised (1:1) to Sleepio or a wait-list control. Feasibility outcomes include recruitment and retention rates, intervention adherence (completion of \u22654\/6 sessions), and acceptability measured using validated usability scales. Secondary outcomes include changes in sleep, mood, QoL, cognition, and function over 10 weeks. Adverse events will be monitored to assess safety. Findings will inform the design of a future definitive trial evaluating digital sleep interventions in cognitively impaired populations. Ethical approval has been granted. The trial is registered at ClinicalTrials.gov (NCT07363928).<\/jats:p>","DOI":"10.3390\/ijerph23060695","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:26Z","timestamp":1779696386000},"page":"695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Randomised Evaluation of Sleep in Cognitive Impairment Trial (REST)\u2014Protocol for a Feasibility Study of a Digital Cognitive Behavioural Therapy for Insomnia Intervention"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9767-5907","authenticated-orcid":false,"given":"Patrick","family":"Crowley","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, T12WE28 Cork City, Ireland"},{"name":"Regional Specialist Memory Clinic, Mercy University Hospital, Lancaster Gate Building, Western Road, T12Y63C Cork City, Ireland"},{"name":"Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork City, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alasdair L.","family":"Henry","sequence":"additional","affiliation":[{"name":"Big Health Ltd., London WC1H 9LT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"O\u2019Donovan","sequence":"additional","affiliation":[{"name":"Regional Specialist Memory Clinic, Mercy University Hospital, Lancaster Gate Building, Western Road, T12Y63C Cork City, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Regional Specialist Memory Clinic, Mercy University Hospital, Lancaster Gate Building, Western Road, T12Y63C Cork City, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork City, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1499-673X","authenticated-orcid":false,"given":"R\u00f3n\u00e1n","family":"O\u2019Caoimh","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, T12WE28 Cork City, Ireland"},{"name":"Regional Specialist Memory Clinic, Mercy University Hospital, Lancaster Gate Building, Western Road, T12Y63C Cork City, Ireland"},{"name":"Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork City, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Shah, A.S., Pant, M.R., Bommasamudram, T., Nayak, K.R., Roberts, S.S.H., Gallagher, C., Vaishali, K., Edwards, B.J., Tod, D., and Davis, F. (2025). Effects of Sleep Deprivation on Physical and Mental Health Outcomes: An Umbrella Review. Am. J. Lifestyle Med., 15598276251346752.","DOI":"10.1177\/15598276251346752"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"afae178.346","DOI":"10.1093\/ageing\/afae178.346","article-title":"Associations Between Sleep and Cognition Among Middle-Aged and Older Adults in Europe","volume":"53","author":"Crowley","year":"2024","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1093\/aje\/kwp023","article-title":"Sleep duration in the United States: A cross-sectional population-based study","volume":"169","author":"Krueger","year":"2009","journal-title":"Am. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s13670-019-00300-x","article-title":"Insomnia in older adults","volume":"8","author":"Nguyen","year":"2019","journal-title":"Curr. Geriatr. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1207\/S15402010BSM0104_5","article-title":"Insomnia as a health risk factor","volume":"1","author":"Taylor","year":"2003","journal-title":"Behav. Sleep Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101205","DOI":"10.1016\/j.smrv.2019.07.008","article-title":"Insomnia and cognitive performance: A systematic review and meta-analysis","volume":"48","author":"Slavish","year":"2019","journal-title":"Sleep Med. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Meng, M., Shen, X., Xie, Y., Lan, R., and Zhu, S. (2025). Insomnia and risk of all-cause dementia: A systematic review and meta-analysis. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0318814"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4899","DOI":"10.1007\/s11357-025-01637-2","article-title":"Sleep disorders increase the risk of dementia, Alzheimer\u2019s disease, and cognitive decline: A meta-analysis","volume":"47","author":"Ungvari","year":"2025","journal-title":"GeroScience"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.neuroscience.2024.08.008","article-title":"Alzheimer\u2019s disease and sleep disorders: A bidirectional relationship","volume":"557","author":"Chen","year":"2024","journal-title":"Neuroscience"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.5665\/sleep.6240","article-title":"Reduced slow-wave sleep is associated with high cerebrospinal fluid A\u03b242 levels in cognitively normal elderly","volume":"39","author":"Varga","year":"2016","journal-title":"Sleep"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Reddy, O.C., and van der Werf, Y.D. (2020). The sleeping brain: Harnessing the power of the glymphatic system through lifestyle choices. Brain Sci., 10.","DOI":"10.3390\/brainsci10110868"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101252","DOI":"10.1016\/j.arr.2020.101252","article-title":"Brain changes associated with sleep disruption in cognitively unimpaired older adults: A short review","volume":"66","author":"Laniepce","year":"2021","journal-title":"Ageing Res. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s41105-022-00439-9","article-title":"Sleep disorders affect cognitive function in adults: Overview of systematic reviews","volume":"21","author":"Kong","year":"2023","journal-title":"Sleep Biol. Rhythm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"918","DOI":"10.12688\/f1000research.8729.1","article-title":"Hypnotic drug risks of mortality, infection, depression, and cancer: But lack of benefit","volume":"5","author":"Kripke","year":"2016","journal-title":"F1000Research"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"457","DOI":"10.30773\/pi.2023.0383","article-title":"Association Between Hypnotics and Dementia: A Mini Narrative Review","volume":"21","author":"Yoon","year":"2024","journal-title":"Psychiatry Investig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"117","DOI":"10.14283\/jpad.2023.78","article-title":"Relationships of Hypnotics with Incident Dementia and Alzheimer\u2019s Disease: A Longitudinal Study and Meta-Analysis","volume":"11","author":"Hou","year":"2024","journal-title":"J. Prev. Alzheimer\u2019s Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.maturitas.2019.06.007","article-title":"Non-pharmacological treatments for sleep disturbance in mild cognitive impairment and dementia: A systematic review and meta-analysis","volume":"127","author":"Mannion","year":"2019","journal-title":"Maturitas"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2147\/NSS.S201994","article-title":"Targeting Orexin Receptors for the Treatment of Insomnia: From Physiological Mechanisms to Current Clinical Evidence and Recommendations","volume":"15","author":"Mogavero","year":"2023","journal-title":"Nat. Sci. Sleep"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.5664\/jcsm.8986","article-title":"Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline","volume":"17","author":"Edinger","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"125","DOI":"10.7326\/M15-2175","article-title":"Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline from the American College of Physicians","volume":"165","author":"Qaseem","year":"2016","journal-title":"Ann. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e14035","DOI":"10.1111\/jsr.14035","article-title":"European insomnia guideline: An update on the diagnosis and treatment of insomnia 2023","volume":"32","author":"Riemann","year":"2023","journal-title":"J. Sleep Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1177\/0269881119855343","article-title":"British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update","volume":"33","author":"Wilson","year":"2019","journal-title":"J. Psychopharmacol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Crowley, P., O\u2019Donovan, M.R., Leahy, P., Flanagan, E., and O\u2019Caoimh, R. (2025). Pharmacological and Non-Pharmacological Interventions to Improve Sleep in People with Cognitive Impairment: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22060956"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1080\/07317115.2017.1384777","article-title":"Neuropsychological Functioning in Older Adults with Mild Cognitive Impairment and Insomnia Randomized to CBT-I or Control Group","volume":"41","author":"Siebern","year":"2018","journal-title":"Clin. Gerontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1080\/15402002.2018.1518223","article-title":"\u201cSleep Well, Think Well\u201d Group Program for Mild Cognitive Impairment: A Randomized Controlled Pilot Study","volume":"17","author":"Naismith","year":"2019","journal-title":"Behav. Sleep Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1460458216656472","article-title":"A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia","volume":"24","author":"Koffel","year":"2018","journal-title":"Health Inform. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.sleep.2020.08.020","article-title":"Efficacy of digital cognitive behavioural therapy for insomnia: A meta-analysis of randomised controlled trials","volume":"75","author":"Soh","year":"2020","journal-title":"Sleep Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.smrv.2015.10.004","article-title":"Efficacy of internet-delivered cognitive-behavioral therapy for insomnia\u2014A systematic review and meta-analysis of randomized controlled trials","volume":"30","author":"Zachariae","year":"2016","journal-title":"Sleep Med. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lee, Y., Kim, I., Lee, S., and Yu, S. (2024). Information and Communication Technology-Based Application for Cognitive Behavioral Therapy among Community-Dwelling Older Adults with Insomnia: Development and Validation Study. Healthcare, 12.","DOI":"10.3390\/healthcare12010106"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.3233\/JAD-210657","article-title":"Feasibility and Preliminary Efficacy of an Internet-Delivered Intervention for Insomnia in Individuals with Mild Cognitive Impairment","volume":"84","author":"Mattos","year":"2021","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Hoyos, C., Espinosa, N., Marshall, N., LaMonica, H., Gordon, C.J., Kyle, S., Grunstein, R.R., and Naismith, S.L. (2026). Digital Cognitive Behavioural Therapy for Insomnia Compared to Sleep Health Education in Older Adults with Mild Cognitive Impairment and Insomnia: A Feasibility Randomised Controlled Trial. J. Sleep Res., e70317.","DOI":"10.1111\/jsr.70317"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1001\/jamapsychiatry.2018.2745","article-title":"Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial","volume":"76","author":"Espie","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"769","DOI":"10.5665\/sleep.1872","article-title":"A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application","volume":"35","author":"Espie","year":"2012","journal-title":"Sleep"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"zsaa034","DOI":"10.1093\/sleep\/zsaa034","article-title":"The effects of digital cognitive behavioral therapy for insomnia on cognitive function: A randomized controlled trial","volume":"43","author":"Kyle","year":"2020","journal-title":"Sleep"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1080\/13607863.2025.2480124","article-title":"Efficacy of digital cognitive behavioral therapy for treating insomnia in adults aged 65 and older: A secondary analysis using individual participant data from three randomized controlled trials","volume":"29","author":"Tarnai","year":"2025","journal-title":"Aging Ment. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e75359","DOI":"10.2196\/75359","article-title":"Encouraging General Practitioners to Refer Patients with Insomnia to a Digital Therapeutic (Sleepio): Feasibility Repeated-Measures Intervention Study","volume":"9","author":"Alkhaldi","year":"2025","journal-title":"JMIR Form. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/0733464816642582","article-title":"A New Tool for Assessing Mobile Device Proficiency in Older Adults: The Mobile Device Proficiency Questionnaire","volume":"37","author":"Roque","year":"2018","journal-title":"J. Appl. Gerontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e004183","DOI":"10.1136\/bmjopen-2013-004183","article-title":"The Sleep Condition Indicator: A clinical screening tool to evaluate insomnia disorder","volume":"4","author":"Espie","year":"2014","journal-title":"BMJ Open"},{"key":"ref_39","first-page":"653","article-title":"Functional assessment staging (FAST)","volume":"24","author":"Reisberg","year":"1988","journal-title":"Psychopharmacol. Bull."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1001\/archneur.56.3.303","article-title":"Mild cognitive impairment: Clinical characterization and outcome","volume":"56","author":"Petersen","year":"1999","journal-title":"Arch. Neurol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2412","DOI":"10.1212\/WNL.43.11.2412-a","article-title":"The Clinical Dementia Rating (CDR): Current version and scoring rules","volume":"43","author":"Morris","year":"1993","journal-title":"Neurology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.2196\/jmir.1772","article-title":"A systematic review of the impact of adherence on the effectiveness of e-therapies","volume":"13","author":"Donkin","year":"2011","journal-title":"J. Med. Internet Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/sleep\/32.6.807","article-title":"Logging on for better sleep: RCT of the effectiveness of online treatment for insomnia","volume":"32","author":"Vincent","year":"2009","journal-title":"Sleep"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e43727","DOI":"10.2196\/43727","article-title":"Assessing Patient Adherence to and Engagement with Digital Interventions for Depression in Clinical Trials: Systematic Literature Review","volume":"25","author":"Forbes","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Jordan, P.W., Thomas, B., Weerdmeester, B.A., and McClelland, A.L. (1996). SUS: A Quick and Dirty Usability Scale. Usability Evaluation in Industry, Taylor & Francis.","DOI":"10.1201\/9781498710411"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Lewis, J.R., Utesch, B.S., and Maher, D.E. (2013). UMUX-LITE: When There\u2019s No Time for the SUS. SIGCHI Conference on Human Factors in Computing Systems, Association for Computing Machinery.","DOI":"10.1145\/2470654.2481287"},{"key":"ref_48","unstructured":"Morin, C.M. (1996). Insomnia: Psychological Assessment and Management, Guilford Press."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jad.2008.06.026","article-title":"The PHQ-8 as a measure of current depression in the general population","volume":"114","author":"Kroenke","year":"2009","journal-title":"J. Affect. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/geront\/39.1.25","article-title":"Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL)","volume":"39","author":"Brod","year":"1999","journal-title":"Gerontologist"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1176\/ajp.141.11.1356","article-title":"A new rating scale for Alzheimer\u2019s disease","volume":"141","author":"Rosen","year":"1984","journal-title":"Am. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"471","DOI":"10.5014\/ajot.53.5.471","article-title":"Development of a functional measure for persons with Alzheimer\u2019s disease: The disability assessment for dementia","volume":"53","author":"Gauthier","year":"1999","journal-title":"Am. J. Occup. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/104012371302500208","article-title":"Rapid screening for perceived cognitive impairment in major depressive disorder","volume":"25","author":"Iverson","year":"2013","journal-title":"Ann. Clin. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ijsu.2011.10.001","article-title":"CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials","volume":"10","author":"Moher","year":"2012","journal-title":"Int. J. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s40266-018-0569-8","article-title":"Insomnia in Elderly Patients: Recommendations for Pharmacological Management","volume":"35","author":"Abad","year":"2018","journal-title":"Drugs Aging"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2165\/11599460-000000000-00000","article-title":"Medication-related falls in the elderly: Causative factors and preventive strategies","volume":"29","author":"Huang","year":"2012","journal-title":"Drugs Aging"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Scharner, V., Hasieber, L., S\u00f6nnichsen, A., and Mann, E. (2022). Efficacy and safety of Z-substances in the management of insomnia in older adults: A systematic review for the development of recommendations to reduce potentially inappropriate prescribing. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-02757-6"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e479","DOI":"10.1016\/S2666-7568(21)00140-9","article-title":"Mortality rates in Alzheimer\u2019s disease and non-Alzheimer\u2019s dementias: A systematic review and meta-analysis","volume":"2","author":"Liang","year":"2021","journal-title":"Lancet Healthy Longev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/BF01321316","article-title":"Sleep problems in the community elderly as predictors of death and nursing home placement","volume":"15","author":"Pollak","year":"1990","journal-title":"J. Community Health"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"The Lancet Diabetes Endocrinology (2024). Sleep: A neglected public health issue. Lancet Diabetes Endocrinol., 12, 365.","DOI":"10.1016\/S2213-8587(24)00132-3"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/jgs.12649","article-title":"Sleep disturbances and risk of falls in older community-dwelling men: The outcomes of sleep disorders in older men (MrOS sleep) study","volume":"62","author":"Stone","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.sleep.2012.04.010","article-title":"Sleep disturbances and risk of frailty and mortality in older men","volume":"13","author":"Ensrud","year":"2012","journal-title":"Sleep Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"473","DOI":"10.31887\/DCNS.2008.10.4\/plfranzen","article-title":"Sleep disturbances and depression: Risk relationships for subsequent depression and therapeutic implications","volume":"10","author":"Franzen","year":"2008","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.cct.2010.12.007","article-title":"The use and abuse of multiple outcomes in randomized controlled depression trials","volume":"32","author":"Tyler","year":"2011","journal-title":"Contemp. Clin. Trials"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13063-021-05975-2","article-title":"Multiple secondary outcome analyses: Precise interpretation is important","volume":"23","author":"Parker","year":"2022","journal-title":"Trials"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"d40","DOI":"10.1136\/bmj.d40","article-title":"Strategy for intention to treat analysis in randomised trials with missing outcome data","volume":"342","author":"White","year":"2011","journal-title":"BMJ"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Bell, M.L., Fiero, M., Horton, N.J., and Hsu, C.H. (2014). Handling missing data in RCTs; A review of the top medical journals. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-118"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/pst.185","article-title":"Sample size of 12 per group rule of thumb for a pilot study","volume":"4","author":"Julious","year":"2005","journal-title":"Pharm. Stat."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s40814-023-01416-w","article-title":"A review of sample sizes for UK pilot and feasibility studies on the ISRCTN registry from 2013 to 2020","volume":"9","author":"Totton","year":"2023","journal-title":"Pilot Feasibility Stud."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1001\/jamainternmed.2025.4610","article-title":"Cognitive Behavioral Therapy for Insomnia in People with Chronic Disease: A Systematic Review and Meta-Analysis","volume":"185","author":"Scott","year":"2025","journal-title":"JAMA Intern. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1001\/jamainternmed.2026.0048","article-title":"Cognitive Behavioral Therapy for Insomnia in Chronic Disease-Reply","volume":"186","author":"Scott","year":"2026","journal-title":"JAMA Intern. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.pop.2022.04.002","article-title":"The State of Telehealth Before and After the COVID-19 Pandemic","volume":"49","author":"Shaver","year":"2022","journal-title":"Prim. Care"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1016\/S0140-6736(15)60461-5","article-title":"A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial","volume":"385","author":"Ngandu","year":"2015","journal-title":"Lancet"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1002\/alz.12123","article-title":"World-Wide FINGERS Network: A global approach to risk reduction and prevention of dementia","volume":"16","author":"Kivipelto","year":"2020","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2559","DOI":"10.1111\/ene.15391","article-title":"The European Academy of Neurology Brain Health Strategy: One brain, one life, one approach","volume":"29","author":"Bassetti","year":"2022","journal-title":"Eur. J. Neurol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/6\/695\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:08:55Z","timestamp":1779696535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/6\/695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":77,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["ijerph23060695"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23060695","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]}}}