The WISE Study (WhatsApp Intervention for Sleep in the Elderly)

• Nurse-led WiSE intervention group (Other): Upon arrival at the initial meeting, participants will receive a workbook containing an overview and content of WISE, including sleep disorders, symptoms, causes of insomnia, sleep hygiene, and relaxation. At the beginning of the intervention and at the end of the fourth week after the intervention, an interventional nurse will meet with participants to assess their Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Geriatric Depression Scale-Short Form (GDS-SF), Brief Fatigue Inventory (BFI), Epworth Sleepiness Scale (ESS), and sleep diary. From week 1 to week 4, participants will receive daily education via WhatsApp.

Primary outcomes

• Changes in Insomnia Severity [At baseline to week 4 (after the intervention), and one month (follow-up)]: Insomnia severity will be measured using the Indonesian version of the Insomnia Severity Index (ISI). The ISI has seven questions to assess sleep difficulties. The total score ranges from 0 to 28, with scores above 7 being associated with insomnia. Higher scores indicate more severe insomnia.
• Changes in Epworth Sleepiness [At baseline to week 4 (after the intervention), and one month (follow-up)]: Epworth Sleepiness will be measured using the Indonesian version of Epworth Sleepiness Scale (ESS) with a 8-item questionnaires with total scores 24. Higher scores presence of ESS.
• Changes in Sleep parameters from sleep logs [At baseline to week 4 (after the intervention), and one month (follow-up)]: Sleep parameters will be measured using Sleep Logs with a-6 item questionnaires that assess for daily sleep log. Higher scores presence poor of sleep

Secondary outcomes

• Changes in level of Anxiety [At baseline to week 4 (after the intervention), and one month (follow-up)]: Level of anxiety will be measured using the Indonesian version of the Insomnia Generalized Anxiety Disorder-7 (GAD-7). The total score ranges from 0 to 21. Higher scores indicate more depression.
• Changes in level of depression [At baseline to week 4 (after the intervention), and one month (follow-up)]: Level of depression will be measured using the Indonesian version of Geriatric Depression Scale-Short Form (GDS-SF) with a 15-item questionnaire that assesses the level of depression. Higher scores indicate more depression.
• Changes in level of fatigue in a person - both in terms of intensity and its impact on daily activities [At baseline to week 4 (after the intervention), and one month (follow-up)]: Level of fatigue will be measured using the Indonesian version of Brief Fatigue Inventory (BFI) with a 9-item questionnaire that assesses the level and impact of fatigue in the past 24 hours using a scale of 0-10, with the final score being the average of all items. Higher scores indicate more severe fatigue.

Sex: All, ages: 60 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Elderly individuals diagnosed with loneliness
* Reported experiencing sleep disturbances in the past 2 weeks, either continuously or intermittently
* Experiencing insomnia with a total score of ≥ 8 on the Indonesian version of the Insomnia Severity Index (ISI) during screening
* Able to communicate in Indonesian

Exclusion Criteria:

* Elderly individuals with dementia, delirium, severe mental retardation, or cognitive impairment that prevents them from understanding or assessing their own sleep experience.
* Currently using new sleeping medication/stimulants

• Hasan F, Prasetya EC, Gordon CJ, Romadlon DS, Chang KM, Bartlett DJ, Lin CJ, Gautama MSN, Izzati N, Chiu HY. Effects of nurse-led, web-based brief behavioral therapy on insomnia severity in patients in the chronic stage of stroke recovery: a preliminary randomized controlled trial. J Clin Sleep Med. 2025 Dec 1;21(12):2031-2040. doi: 10.5664/jcsm.11856. PMID 40904277

• Study Protocol and Statistical Analysis Plan: Study Protocol WISE (PDF, 2025-10-10)
• Study Protocol and Statistical Analysis Plan: Study Protocol updated (PDF, 2025-10-10)