A Culturally Adapted Sleep Intervention Program for Older Asian Immigrants with Limited English Proficiency

Project Summary/Abstract Poor sleep is common among Asian Americans. Untreated sleep problems increase the risk of chronic diseases, cognitive decline, and mortality. Cognitive behavioral therapy for insomnia (CBTI) is considered the first-line treatment for chronic sleep problems and has demonstrated significant improvement in sleep health among older adults. However, existing CBTI is built upon Western culture, making it challenging to apply for Asian immigrants who maintain close ties to their native cultures that shape and influence their sleep habits. Addressing the lack of availability of a culturally adapted sleep intervention program is the first step to filling the gap in sleep health disparity among Asian immigrants. The current proposal aims to develop a culturally adapted sleep intervention program for older Korean immigrants with poor sleep and to evaluate its feasibility and preliminary efficacy. In Year 1 of the project, using the cultural adaptation strategies guided by Barrera and colleagues and prior studies, we will refine an existing behavioral sleep intervention program built upon the core components of CBTI with input and feedback from key stakeholders and older Korean immigrants in a community setting. Next, we will train a sleep educator to deliver the intervention at a community-based agency serving older Korean immigrants. In Year 2 of the study, we will conduct a pilot randomized clinical trial in which the study participant (N=32) will be randomized to either (a) our culturally adapted sleep intervention group or (b) the control group (general sleep education only). We will evaluate the feasibility of the intervention and the preliminary effects of the intervention on sleep health outcomes among Korean immigrants. The knowledge gained from this study can potentially improve the lives of Asian immigrants with poor sleep. If our sleep intervention program is acceptable and feasible for delivery in the community setting and shows superior clinical outcomes compared to the control group, the preliminary findings will pave the way for a larger clinical trial to examine the efficacy of the sleep intervention in the long term. The intervention manual is scalable and can be easily delivered by staff in various community settings. It also has the potential to increase its accessibility and adherence to the intervention recommendation.