# SleepHab: Effectiveness of Healthy Sleep Habits for Hospitalized Older Adults to Optimize Rehabilitation

> **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2021 · $516,978

## Abstract

PROJECT SUMMARY/ABSTRACT
Consistent with NINR and NCMRR priorities to address sleep disorders in the context of rehabilitation, this
proposal aims to evaluate the efficacy of a nonpharmacological intervention for insomnia among older patients
recovering from hip or knee arthroplasty. Almost half of the 15 million older patients hospitalized each year
report disrupted sleep during their hospital visit. Sleep complaints can persist for several months following
hospitalization and are associated with functional impairment during and following discharge. Further, daytime
sequela of insomnia, such as diminished attention/concentration and fatigue, may serve to undermine and limit
the effectiveness of rehabilitation. Thus, the proposed study aims to evaluate a much-needed safe treatment
for insomnia (cognitive behavioral therapy for insomnia) in conjunction with medical rehabilitation to manage
insomnia symptoms and promote functional health. Improving sleep is expected to enhance rehabilitation, by
increasing patients' abilities to attend and adhere to rehabilitation recommendations. To maximize the public
health impact, improve access, and reduce treatment barriers (stigma and transportation issues), we propose
to evaluate the efficacy and effectiveness of the intervention delivered by nurses and physical and
occupational therapists hospital bedside and in the home environment. The central hypothesis is that tailored
CBTI delivered during and following hospitalization will improve sleep and functional outcomes in older adults
receiving medical rehabilitation and is guided by the following aims: (1) to evaluate the efficacy of CBTI in a
randomized, placebo-controlled trial, and (2) to determine the effectiveness of CBTI on rehabilitation and
health outcomes. Primary outcomes, for which the study is optimally designed and sufficiently powered, are
subjectively- and objectively-measured sleep. Secondary outcomes, for which we are unable to estimate power
are functional (motor, cognition, independence) outcomes. We will also explore the relationship of treatment
response to other health outcomes, including level of inflammation, medication use, fatigue, pain intensity, and
depressive symptom severity. Our team has extensive experience in designing and implementing behavioral
health clinical trials for older adults within hospital and community-based settings. If effective the sleep
intervention has the potential to optimize functional gains in rehabilitation and reduce adverse health
outcomes, thereby improving quality of life and reducing significant costs to society.

## Key facts

- **NIH application ID:** 10073549
- **Project number:** 5R01NR018342-03
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Sara Nowakowski
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $516,978
- **Award type:** 5
- **Project period:** 2019-02-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10073549

## Citation

> US National Institutes of Health, RePORTER application 10073549, SleepHab: Effectiveness of Healthy Sleep Habits for Hospitalized Older Adults to Optimize Rehabilitation (5R01NR018342-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10073549. Licensed CC0.

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