Culturally Adapted Lifestyle and Mind–body approaches for SLEEP health (CALM-SLEEP) – Co-developing a Culturally Tailored, Non-Drug Intervention for Older Adults with Subjective Cognitive Decline

Funding

NHS Bristol, North Somerset and South Gloucestershire ICB Research Capability Funding.

What is the problem?

Sleep problems are common in later life, affecting around one in three adults aged 65+ and frequently prompting GP consultations. Poor sleep can impair daily functioning, reduce quality of life, and is closely linked to subjective cognitive decline (SCD) – early memory concerns that may indicate increased risk of later dementia. As sleep is now recognised as a modifiable dementia risk factor, it represents an important target for early intervention, prevention, and healthier ageing. Sleep and memory concerns are even more common in underserved ethnic minority communities, where culturally inappropriate services can reduce trust, access, and long-term engagement, contributing to widening inequalities.

Sleep problems are often treated with medication despite known risks, including falls, confusion, and dependency. Although non-drug approaches such as mind–body practice and nutrition-based support show promise, they are rarely integrated or culturally tailored for routine care.

This project addresses an important evidence and service gap by developing earlier, safer, community-based support for sleep and brain health. It aligns with DHSC Areas of Research Interest3 by supporting prevention and reducing inequalities, reducing avoidable service demand, and testing a scalable low-burden model of care. It also aligns with ICB priorities on prevention, tackling inequalities, community partnership, and healthy ageing.

Describe the work to be undertaken for the RCF

The RCF will support the co-design and refinement of a culturally adapted community intervention, informing a competitive NIHR application to improve sleep and support early brain health in older adults from diverse ethnic communities. Building on our previous work in mind–body practice and nutrition education, this project will develop a practical programme to help older adults sleep better and support brain health.

We will work with older adults from White British, Chinese and South Asian communities who have sleep problems and early memory concerns, identified through community organisations, existing networks and primary care links. Using a Person-Based Approach, including Patient and Public Involvement (PPI) co-production workshops and material-testing sessions with think-aloud techniques, we will ensure the intervention is understandable, acceptable, culturally relevant and practical for community delivery.

We will also involve carers, community leaders, voluntary organisations, GPs, community practitioners, commissioners and other BNSSG stakeholders. Their input will help identify gaps in current support, strengthen recruitment and referral pathways, and explore opportunities for earlier, safer community-based care.

The RCF will produce a co-designed intervention package, participant materials, a logic model, draft trial protocol, agreed outcomes, and a primary care–community recruitment and referral pathway for a future NIHR feasibility application.

Describe the work to be undertaken for the intended NIHR funded project

The overall aim of the planned NIHR-funded study is to evaluate the feasibility, acceptability, and implementation readiness of the CALM-SLEEP intervention for people with SCD who are experiencing sleep disturbance, in order to inform the design of a future definitive trial.

Older adults experiencing poor sleep and early memory concerns will be recruited through primary care and community referral pathways. Participants will take part in a structured group programme delivered by trained facilitators. The programme will combine simple mind–body strategies, such as breathing exercises and gentle movement, with culturally relevant practical advice on nutrition, sleep habits, and daily routines to improve sleep without relying on medication.

The programme will be compared with usual care to assess feasibility and implementation outcomes, including recruitment, retention, adherence, intervention uptake, and acceptability. Clinical outcomes will be assessed as exploratory candidates to inform the selection of a primary endpoint for a future definitive trial, including sleep quality and wellbeing, alongside simple objective sleep monitoring using wrist-worn devices.

Findings will inform a future definitive trial and support the development of a scalable, community-based model for earlier intervention, reducing reliance on medication and strengthening prevention within dementia care pathways.

Who is leading the research?

This research is led by Dr Sunny Chan, Senior Lecturer, School of Health and Social Wellbeing, School of Health and Social Wellbeing, University of the West of England, Bristol (UWE).

Further information

For more information or to get involved with this project, please email bnssg.research@nhs.net