Disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. Yet nursing home (NH) routines frequently disturb residents’ sleep through use of noise and light or efforts, for example, to reduce incontinence. NH residents with Alzheimer’s disease or related dementia (ADRD)—almost two-thirds of long-stay NH residents—are likely to be particularly affected by sleep disturbance. This study tackles these important issues and substantially moves forward goals of the National Plan to Address Alzheimer’s Disease 2018 Update by proposing to implement an evidence-based intervention to improve sleep: a NH front line staff huddling program known as LOCK. The LOCK program is derived from evidence supporting strengths-based learning, systematic observation, relationship-based teamwork, and efficiency.

In NHs from 3 NH corporations, the study has (1) refine the LOCK program to focus on sleep for residents with ADRD in an R61 phase, (2) test the impact of the LOCK sleep program for NH residents with ADRD in an R33 phase, and (3) evaluate the program’s sustainability. The R33 phase (4 years; n = 24 NHs; 8 NHs per corporation) has the following specific aims: (1) Implement the LOCK-based sleep program for residents with ADRD using the train-the-trainer model. (2) Estimate impact of the LOCK sleep program on sleep (primary outcome) and on psychotropic medication use, pain and analgesic medication use, and activities of daily living decline (secondary outcomes). (3) Examine factors, using mixed methods, associated with variation in the program’s implementation and its sustainability. This innovative program also has future potential to address other important issues (safety, infection control) and expand to other settings (assisted living, inpatient mental health). The study’s strong team, careful consideration of design challenges, and resulting rigorous, pragmatic approach will ensure success of this promising intervention for NH residents with ADRD.

Dr. A. Lynn Snow, PhD

Principal Investigator


Project Staff

Brian Cox, MS, Project Director, (205) 348-7518, brian.cox@ua.edu

Brian has worked for the University of Alabama and the Alabama Research Institute on Aging since 2009. First as a project manager until he was promoted to program manager in 2016.  During his time with ARIA he has managed a variety of aging research projects, funded at over $12 million, focused on a wide range of topics including arthritis, family care giving, memory disorders, lupus, COVID-19 vaccination efforts, pain, and sleep disorders.  Brian received his BS in Psychology from the University of Mary Washington in 2006 and his Masters in Higher Education Administration from the University of Alabama in 2023.

Vanessa Aguilar, MS, Project Manager, vgaguilar@ua.edu

Vanessa joined the 40Winks team at the University of Alabama in the Fall of 2023. She began her research endeavors in 2019 at the University of Texas at Austin where she helped coordinate trials for mild cognitive impairment (MCI) in older adults with sleep apnea and restless leg syndrome (RLS) in nursing home residents diagnosed with dementia. Since then, she has branched out to research in pediatric migraines and medical device implants for cervical and lumbar pain management and arthritis. 

Vanessa received her Bachelor of Science in Behavioral Neuroscience in 2019 from St. Edward’s University in Austin, TX and her Master of Science in Biomedical Sciences in 2021 from the University of the Incarnate Word School of Osteopathic Medicine in San Antonio, TX. 

Graduate Research Assistants

Kate Smith, MS, kdsmith33@crimson.ua.edu

Kate Smith is a fourth-year doctoral graduate student in the Geropsychology track of the Clinical Psychology program at the University of Alabama. Her research interests include nonpharmacological interventions and person-centered care strategies in long term care, caregiver burden, mindfulness, and quality of life. She completed her master’s in clinical psychology at Minnesota State University in 2020 and is presently working with the 40 Winks team as a graduate research assistant.

Mentors: Dr. A. Lynn Snow, Dr. Michelle Hilgeman

Regina George, MS, rageorge2@crimson.ua.edu

Regina is a graduate student in the Ph.D. Clinical Psychology program with a focus in geropsychology at the University of Alabama. Her research interests are in quality improvement and implementation science in long term care facilities, health disparities and care giving.

Mentors: Dr. A. Lynn Snow, Dr. Michelle Hilgeman

Sophia Gesser, srgeisser@crimson.ua.edu

Sophia is a PhD student in Clinical Psychology (Geropsychology emphasis), at the University of Alabama. Sophia’s research interests include sleep and dementia, assessing care partner burden, mindfulness, identifying racial, ethnic, and socioeconomic disparities in end-of-life care, and creating practical and inclusive tools to promote health equity.

Sophia graduated from Binghamton University with a BS in Integrative Neuroscience and a BA in Theatre Dance.

Mentors: Dr. A. Lynn Snow, Dr. Michelle Hilgeman

Undergraduate Research Assistants

Blake Eversmann

Blake is a junior at the University of Alabama, and he is graduating with a BS in Psychology with minors in Political Science and Communication. He is also graduating with honors as a member of the Honors College. In addition, Blake is a member of the Alabama Forensic Council, the University’s speech and debate team. He was born in Birmingham, Alabama, but was raised in Harrisburg, Illinois. After graduation, Blake hopes to pursue a PhD in Clinical Psychology. Within Psychology, Blake is interested in pursuing child psychology, but is unsure of the specific range he’d like to work with. Outside of Psychology and research, he’s an avid enjoyer of classic literature, photography, and cooking.

Chinasa Anthony

Chinasa is a freshman at the University of Alabama, majoring in Neuroscience and minoring in Medical Ethics. He is a member of the Honors College at the university. Born and raised in Seattle, Washington, Chinasa is interested in Neuroethics and plans to pursue a law degree after university. Outside of school, he enjoys watching and playing soccer, basketball, and video games.

Jack Alford

Jack is an undergraduate research assistant for the 40 Winks project. He is a junior at The University of Alabama and is from Camden, Alabama. He is majoring in Biology and Psychology and is enrolled in the University Honors Program. After graduation, Jack plans to attend medical school, and his areas of interest are neurology and endocrinology as well as rural health. In his free time, Jack enjoys volunteering, being with friends and family, and the outdoors.

Jaden Hylton

Jaden is an Undergraduate Research Assistant for the 40 Winks project. She is a Junior at the University of Alabama and is planning to graduate with a BS in Anthropology and a minor in Biology. She is currently on the Pre-health track and hopes to pursue a degree in medicine and specialize in chronic pain management. She has a passion for art, French and astrology, and is the Vice president of the Astronomical Society. She enjoys engaging in music and art therapy with patients receiving hospice care and is also a member of several art clubs here on campus. Jaden’s specific research interests surround improving health disparities, chronic pain management, opiate dependence and palliative care. In her free time, she enjoys gardening, hiking, and spending time with her pets.

Jordan Kramer

Jordan is a senior graduating in May that has just entered the 40 Winks project this semester. Jordan will be graduating as a double major with a BA in both psychology and criminal justice. After graduation Jordan will be attending graduate school for psychology and has a goal of eventually obtaining a PhD within clinical psychology. Jordan’s research interest are anything that explains a “why” and provides some sort of further understanding about a topic.

Maxwell Street

Stefanie Rodriguez

Stefanie is an undergraduate research assistant for the 40 Winks project. She is a junior at the University of Alabama and is graduating with a BS in Psychology with a minor in Human Development and Family Studies. She is also graduating as a member of Alpha Phi International Fraternity, Psychology club, AURA (Alabama Undergraduate Research Association), and Dean’s List. She was born and raised in the suburbs of Chicago, Illinois. After Graduation, Stefanie hopes to pursue a PhD in Clinical Psychology with a geropsychology focus. Stefanie’s specific research interests are oriented around healthcare and quality of life in older adults, nutrition, memory & mental disorders, and health disparities.