Can mindfulness mechanistically target worry to improve sleep disturbances? Theory and study protocol for app-based anxiety program.
Can mindfulness mechanistically target worry to improve sleep disturbances? Theory and study protocol for app-based anxiety program.
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DOI：
10.1037/hea0000874
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Hoge EA
中科院分区：
文献类型：
--
作者：
Brewer JA;Roy A;Deluty A;Liu T;Hoge EA
焦虑与睡眠障碍和失眠有关。基于正念的干预措施，例如基于正念的减压，已显示出持续的焦虑减轻。正念训练理论上可以影响强化学习，影响吸烟和暴饮暴食等习惯行为，但使用正念训练减少焦虑和改善睡眠之间的直接机制联系尚未被研究。此外，正念影响焦虑和随后的睡眠障碍的机制尚未阐明。该研究方案评估了基于应用程序的焦虑正念训练计划对减少担忧和改善睡眠的影响。一项随机对照研究将在大约 80 名担心干扰睡眠的成年人中进行。受试者将被随机分配 (1:1) 至两组：照常治疗 (TAU) 或 TAU + 基于应用程序的正念训练（MT；Unwinding Anxiety 应用程序）。主要结果将是五方面正念问卷和 PROMIS 睡眠质量测量的非反应性子量表。次要结果将包括宾夕法尼亚州立大学忧虑问卷、广泛性焦虑症 7 和内感受意识量表的多维评估。这项研究首次测试了基于应用程序的正念训练对焦虑和睡眠障碍的作用机制。使用行为改变科学（SOBC）框架测试正念训练的机械效应将有助于推动该领域向前发展，进一步阐明正念的潜在机制（例如，针对强化学习），并确定这样的平台是否可能是大规模和低成本提供高保真治疗的可行方法。
Anxiety is associated with sleep disturbance and insomnia. Mindfulness-based interventions, such as Mindfulness-based Stress Reduction, have shown consistent anxiety reduction. Mindfulness training has been theorized to affect reinforcement learning, affecting habitual behaviors such as smoking and overeating, but a direct mechanistic link between the use of mindfulness training for anxiety reduction and improvement in sleep has not been studied. Moreover, the mechanisms by which mindfulness may affect worry and subsequent sleep disturbances have not been elucidated. This study protocol evaluates the impact an app-based mindfulness training program for anxiety has on decreasing worry, and improvement in sleep. A randomized controlled study will be conducted in approximately 80 adults with worry that interferes with their sleep. Subjects will be randomly allocated (1:1) to two groups: treatment as usual (TAU) or TAU + app-based mindfulness training (MT; Unwinding Anxiety app). The primary outcomes will be the nonreactivity subscale of the Five Facet Mindfulness Questionnaire and PROMIS sleep quality measures. Secondary outcomes will include the Penn State Worry Questionnaire, Generalized Anxiety Disorder-7, and Multidimensional Assessment of Interoceptive Awareness scale. This study is the first to test the mechanism of app-based mindfulness training on worry and sleep disturbance. Testing the mechanistic effects of mindfulness training using the Science of Behavior Change (SOBC) framework will help move the field forward both in further elucidation of potential mechanisms of mindfulness (e.g., targeting reinforcement learning), and determining whether such a platform may be a viable method for delivering high-fidelity treatment at scale and for a low cost.
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