0178 Examining Rates and Change in Insomnia Severity among Veterans Enrolled in an Outpatient Exercise Program

Abstract

Abstract Introduction Exercise moderately improves middle insomnia and sleep quality in older adults. GeroFit is a national structured exercise program for Veterans over age 60 that offers 14 virtual classes per month. Each 60-minute class has a combination of cardiovascular, resistance, flexibility, and balance training and is modified to accommodate the range of functional abilities. The purpose of this analysis was to characterize insomnia symptoms (using the Insomnia Severity Index [ISI]) among GeroFit participants across different time points and examine the impact of attendance on change in insomnia symptoms over time. Methods Veterans in the VA Boston GeroFit program (n=69; 60-93years; Meanage=74.3±8.3; 80.6%male; 80.6%White) were administered the ISI at baseline (n=32), 3-months (n=38), 6-months (n=23), and 12-months (n=21) after enrollment. Participants were categorized by ISI scores: no clinically significant insomnia (ISI=0-7), subthreshold insomnia (ISI=8-14), moderate clinical insomnia (ISI=15-21), and severe clinical insomnia (ISI=22-28). A repeated measures ANOVA was performed to assess for ISI score change over time by attendance rate. Results Veterans attended 64% of the 14 classes per month and exhibited a range of functional ability (Physical Function Subscale [SF-36] scores ranged from 11-29 at baseline). The rates of subthreshold and moderate insomnia were: baseline (15.6%;6.3%), 3-months (26.3%;13.2%), 6-months (30.4%;8.7%), and 12-months (38.1%;9.5%), respectively. Overall, ISI scores remained consistent over time as there were no significant score changes over the first 6 months (p=.121); however, participants with <50% attendance demonstrated a significant increase in ISI scores from baseline to 3months (p=.002). Conclusion Of Veterans participating in the VA Boston GeroFit program, about 1 in 10 reported moderate insomnia and 1 in 4 had subthreshold insomnia. Increasing attendance rates is important for improving sleep quality and more research is needed to clarify the “dose” of exercise required to reap meaningful gains in insomnia symptoms, particularly among Veterans with more severe symptoms. Given that 1/3 of participants reported at least subthreshold insomnia, future studies are needed to better understand whether supplemental interventions (e.g., sleep psychoeducation, stimulus control) might be offered to GeroFit participants with clinically significant insomnia symptoms, to dually target sleep and physical functioning. Support (If Any)