Efficacy and mechanisms of a behavioral therapy for insomnia coexisting with COPD

行为疗法治疗慢性阻塞性肺病合并失眠的疗效和机制

基本信息

  • 批准号:
    9322216
  • 负责人:
  • 金额:
    $ 38.86万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2013
  • 资助国家:
    美国
  • 起止时间:
    2013-09-26 至 2019-07-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Difficulty falling asleep, staying asleep or poor quality sleep (insomnia) is common in people with chronic ob- structive pulmonary disease. Insomnia is related to greater mortality, with four times the risk of mortality for sleep times < 300 minutes. Insomnia is also related to greater morbidity, with 75% greater health care costs than people without insomnia. However, insomnia medications are used with caution in COPD due to potential adverse effects. Common features of COPD such as dyspnea, chronic inflammation, anxiety and depression also affect insomnia and can interfere with therapy outcomes. While cognitive behavioral therapy for insomnia (CBT-I), a therapy that provides guidance on changing unhelpful sleep-related beliefs and behavior, is effective for people with primary insomnia and people with other chronic illnesses, the efficacy and mechanisms of ac- tion of such a therapy are yet unclear in people with COPD. Lack of such knowledge is an important problem, because without it, health care providers will remain ill-equipped to manage patients with both COPD and in- somnia. The long-term goal is to help develop safe and effective non-pharmacological interventions to mini- mize insomnia and its consequences in people with COPD. The objective here is to rigorously test efficacy of two components of insomnia therapy - CBT-I and COPD education (COPD-ED) - in people with coexisting in- somnia and COPD, and to identify mechanisms responsible for therapy outcomes. The central hypothesis is that both CBT-I and COPD-ED will have positive, lasting effects on insomnia and fatigue. This hypothesis is consistent with preliminary data produced by the applicant. The rationale for the proposed study is that once the efficacy and mechanisms of CBT-I and COPD-ED are known, new and innovative approaches for insomnia can be developed to nonpharmacologically minimize insomnia and fatigue, thereby leading to longer, higher quality and more productive lives for people with COPD, and reduced societal cost due to insomnia. Guided by strong preliminary data, the central hypothesis will be tested using a randomized controlled parallel-groups comparison of CBT-I, COPD-ED and non-COPD, non-sleep health education attention control (AC) using a highly efficient 4-group design. Arm 1 comprises 6 weekly sessions of CBT-I+AC; Arm 2=6 sessions of COPD- ED+AC; Arm 3=CBT-I+COPD-ED; and Arm 4=AC. This design will allow completion of the following Specific Aims: 1. Determine the efficacy of individual treatment components, CBT-I and COPD-ED, on insomnia and fatigue. 2. Define mechanistic contributors to the outcomes after CBT-I and COPD-ED. The proposed re- search is a significant, necessary step in the development of effective non-pharmacologic therapies for insom- nia coexisting with COPD. The work proposed in Aims 1 and 2 will provide systematic evidence of efficacy and mechanisms of components of a novel approach to insomnia coexisting with COPD. Results are expected to have great public health significance and positive impact because the identified mechanisms are highly likely to provide new approaches for preventive and therapeutic interventions for insomnia and fatigue in COPD.
描述(由申请人提供):入睡困难、保持睡眠或睡眠质量差(失眠)在慢性阻塞性肺病患者中很常见。睡眠不足与更高的死亡率有关,睡眠时间< 300分钟的死亡率风险为4倍。失眠也与更高的发病率有关,比没有失眠的人多75%的医疗保健费用。然而,由于潜在的不良反应,在COPD中谨慎使用失眠药物。COPD的常见特征如呼吸困难、慢性炎症、焦虑和抑郁也会影响失眠,并可能干扰治疗结果。虽然失眠症认知行为疗法(CBT-I)是一种指导改变无益的睡眠相关信念和行为的疗法,对原发性失眠症患者和其他慢性疾病患者有效,但这种疗法在COPD患者中的疗效和作用机制尚不清楚。缺乏这种知识是一个重要的问题,因为如果没有它,医疗保健提供者将仍然没有能力管理患有COPD和哮喘的患者。长期目标是帮助开发安全有效的非药物干预措施,以减少COPD患者的米泽及其后果。本文的目的是严格测试失眠治疗的两个组成部分- CBT-I和COPD教育(COPD-ED)-在失眠和COPD共存的人群中的疗效,并确定治疗结果的机制。核心假设是CBT-I和COPD-ED都将对失眠和疲劳产生积极,持久的影响。这一假设与申请方提供的初步数据一致。这项研究的基本原理是,一旦知道了CBT-I和COPD-ED的疗效和机制,就可以开发新的和创新的失眠方法,以最大限度地减少失眠和疲劳,从而为COPD患者带来更长,更高质量和更有成效的生活,并降低失眠造成的社会成本。在强有力的初步数据的指导下,将使用高效的4组设计,使用CBT-I、COPD-ED和非COPD、非睡眠健康教育注意力控制(AC)的随机对照平行组比较来检验中心假设。第1组包括每周6次CBT-I+AC治疗;第2组=6次COPD-艾德+AC治疗;第3组=CBT-I+ COPD-艾德;第4组=AC。本设计将允许完成以下具体目标:1。确定个体治疗成分CBT-I和COPD-ED对失眠和疲劳的疗效。2.定义CBT-I和COPD-ED后结局的机制贡献者。拟议的研究是开发有效的非药物疗法治疗COPD合并失眠的重要而必要的一步。目的1和2中提出的工作将提供系统的证据,证明失眠与COPD共存的新方法的有效性和机制。研究结果有望产生重大的公共卫生意义和积极影响,因为所确定的机制极有可能为COPD失眠和疲劳的预防和治疗干预提供新的方法。

项目成果

期刊论文数量(14)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Evaluation of fatigability measurement: Integrative review.
  • DOI:
    10.1016/j.gerinurse.2017.05.014
  • 发表时间:
    2018-01
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Kim I;Hacker E;Ferrans CE;Horswill C;Park C;Kapella M
  • 通讯作者:
    Kapella M
Sleep Patterns During Hospitalization Following Hematopoietic Stem Cell Transplantation.
  • DOI:
    10.1188/15.onf.371-379
  • 发表时间:
    2015-07
  • 期刊:
  • 影响因子:
    1.9
  • 作者:
    Hacker ED;Kapella MC;Park C;Ferrans CE;Larson JL
  • 通讯作者:
    Larson JL
Innovative treatments for adults with obstructive sleep apnea.
  • DOI:
    10.2147/nss.s46818
  • 发表时间:
    2014
  • 期刊:
  • 影响因子:
    3.4
  • 作者:
    Weaver TE;Calik MW;Farabi SS;Fink AM;Galang-Boquiren MT;Kapella MC;Prasad B;Carley DW
  • 通讯作者:
    Carley DW
Efficacy and mechanisms of behavioral therapy components for insomnia coexisting with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial.
行为疗法成分对慢性阻塞性肺疾病共存失眠的功效和机制:随机对照试验的研究方案。
  • DOI:
    10.1186/s13063-016-1334-0
  • 发表时间:
    2016
  • 期刊:
  • 影响因子:
    2.5
  • 作者:
    Kapella,MaryC;Herdegen,JamesJ;Laghi,Franco;Steffen,AlanaD;Carley,DavidW
  • 通讯作者:
    Carley,DavidW
The relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes: An integrative review.
  • DOI:
    10.1111/jocn.13899
  • 发表时间:
    2017-12
  • 期刊:
  • 影响因子:
    4.2
  • 作者:
    Zhu B;Hershberger PE;Kapella MC;Fritschi C
  • 通讯作者:
    Fritschi C
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MARY C KAPELLA其他文献

MARY C KAPELLA的其他文献

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{{ truncateString('MARY C KAPELLA', 18)}}的其他基金

Efficacy and mechanisms of a behavioral therapy for insomnia coexisting with COPD
行为疗法治疗慢性阻塞性肺病合并失眠的疗效和机制
  • 批准号:
    8577030
  • 财政年份:
    2013
  • 资助金额:
    $ 38.86万
  • 项目类别:
Nurse Managed Cognitive Behavioral Therapy for Insomnia in People with COPD
护士管理的认知行为疗法治疗慢性阻塞性肺病患者的失眠
  • 批准号:
    7450124
  • 财政年份:
    2008
  • 资助金额:
    $ 38.86万
  • 项目类别:
Nurse Managed Cognitive Behavioral Therapy for Insomnia in People with COPD
护士管理的认知行为疗法治疗慢性阻塞性肺病患者的失眠
  • 批准号:
    7847442
  • 财政年份:
    2008
  • 资助金额:
    $ 38.86万
  • 项目类别:
Nurse Managed Cognitive Behavioral Therapy for Insomnia in People with COPD
护士管理的认知行为疗法治疗慢性阻塞性肺病患者的失眠
  • 批准号:
    7637477
  • 财政年份:
    2008
  • 资助金额:
    $ 38.86万
  • 项目类别:

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