![]() ![]() They have been implicated in promoting brain plasticity 15, memory formation 16, immune-supportive functions 17, and have recently been inversely related to amyloid burden in older adults 18, 19. Slow waves are dominant low-frequency (i.e., <4 Hz) brain rhythms during deep non-rapid eye movement (NREM) sleep, which are considered to mirror sleep intensity and are fundamental for healthy and consolidated sleep 14. Most pronouncedly, sleep becomes more superficial with age, which is reflected in a decrease of sleep slow waves 12, 13. Sleep in older adults is hallmarked by reduced sleep duration, increased sleep fragmentation, and reduced sleep efficiency 9, 10, 11. In this regard, translating in-lab methods that promote healthy sleep have gained increased attention because sleep could be a key player in promoting brain and body health up until old age 7, 8. However, to establish the potential and limitations of preventive and therapeutic health approaches in real-life settings, studies are needed that identify individual differences, establish predictors for successful applications, and elucidate intended and unintended effects of the prolonged intervention in different contexts. With these technologies, an important platform has been developed to move the findings from well-controlled lab studies to in-field applications 6. In contrast, there is an ever-growing range of mobile health devices and technologies that found their way into the consumer market and into people’s homes, yet clinical validations of most of these applications is lacking 4, 5. While basic and applied research in promoting human health has increased substantially in the last decades, its translation into clinical applications with access for a wider public has lagged behind 1, 2, 3. Novel personalization solutions are needed to address these differences and our findings will guide future designs to effectively deliver auditory sleep stimulations using wearable technology. While slow wave enhancement in healthy older adults is possible in fully remote settings, pronounced inter-individual differences in the response to auditory stimulation exist. We further highlight the existence of pronounced inter- and intra-individual differences in the slow wave response to auditory stimulation and establish predictions thereof. We demonstrate a robust and significant enhancement of slow wave activity on the group-level based on two different auditory stimulation approaches with minor effects on sleep architecture and daily functions. Out of 33 enrolled and screened participants, we report data of 16 participants that received identical intervention. Participants and experimenters performing the assessments were blinded to the condition. Participants were randomized in terms of which intervention condition will take place first using a blocked design to guarantee balance. We assessed slow wave activity as the primary outcome and sleep architecture and daily functions, e.g., vigilance and mood as secondary outcomes, after a two-week mobile auditory slow wave stimulation period and a two-week Sham period, interleaved with a two-week washout period. We present a fully remote, randomized, cross-over trial in healthy adults aged 62–78 years (: NCT03420677). ![]() While auditory stimulation showed a beneficial effect in lab-based studies, it remains unclear whether this stimulation approach could translate to real-life settings. Auditory stimulation has emerged as a promising tool to enhance non-invasively sleep slow waves, deep sleep brain oscillations that are tightly linked to sleep restoration and are diminished with age.
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