Older adults treated with targeted behavioral therapy experienced higher insomnia remission rates and a slower pace of aging compared to those receiving standard sleep education.
RT’s Three Key Takeaways:
- Slower Biological Aging: Older adults who underwent cognitive behavioral therapy for insomnia demonstrated a significantly slower pace of biological aging compared to those who received sleep education alone.
- Higher Remission Rates: Patients receiving behavioral therapy achieved a nearly threefold greater likelihood of insomnia remission than individuals in the informational sleep education control group.
- Modifiable Health Factor: Addressing late-life insomnia through behavioral techniques may serve as a modifiable intervention to help lower long-term risks of age-related conditions, including cardiovascular disease, diabetes, and mortality.
Treating insomnia with cognitive behavioral therapy slowed the pace of biological aging in older adults, according to a new study from UCLA Health published in The Lancet Healthy Longevity.
According to the study, older adults who underwent cognitive behavioral therapy for insomnia (CBT-I) were more likely to achieve insomnia remission and experienced a slower rate of biological aging compared to responses in a control group receiving sleep education.
“Insomnia in older adults is often treated as a quality-of-life issue, but these findings suggest it may also be a modifiable risk factor for how the body ages,” said Dr Judith Carroll, associate professor of psychiatry at UCLA Health and lead author of the study, in a news release. “Just as we counsel patients on physical activity and diet to support healthy aging, this points to sleep as another important behavior worth targeting to improve health.”
Insomnia and Biological Aging
According to researchers, between 10% and 25% of adults over age 65 in the US have clinical insomnia. Prior studies have demonstrated an association between insomnia and advanced biological aging as measured by alterations in DNA methylation, a cellular process by which genes are turned on or off. This acceleration in biological aging subsequently contributes to an increased risk of age-related diseases, including cardiovascular disease, diabetes, and mortality.
In the randomized controlled clinical trial, nearly 100 older adults diagnosed with insomnia were assigned to one of two treatments: CBT-I or sleep education therapy. As described in the report, CBT-I provides structured treatment targeting thoughts and behaviors that perpetuate sleeplessness, conducted over multiple sessions with a trained clinician. In contrast, sleep education therapy offers general informational content regarding sleep and healthy sleep habits without incorporating behavioral techniques.
Trial Findings and Epigenetic Clocks
Investigators collected blood samples prior to the eight-week treatment and again during follow-up visits over the course of two years. Researchers extracted DNA from these samples to evaluate biological aging using three epigenetic clocks: DunedinPACE, GrimAge, and PC-PhenoAge.
Carroll and her team observed that adults who received cognitive behavioral therapy had a nearly threefold greater likelihood of insomnia remission compared to those who received sleep education therapy. In addition, the data showed that insomnia treatment significantly slowed the pace of aging based on the DunedinPACE epigenetic clock.
The study authors highlighted several limitations to their research, noting that all trial participants were recruited from a single healthcare site in Los Angeles, California. The investigators indicated that larger, multisite studies with more diverse cohorts across age, ethnicity, and race will be necessary to confirm the results. Furthermore, the authors stated that additional research is needed to determine whether treatment responses differ by sex or whether alternative insomnia treatments, such as pharmacotherapy or Tai Chi, produce similar effects on biological aging.
