Smartphone-Based Intervention for Sleep Disturbance in Individuals Recovering from Alcohol Use Disorder

基于智能手机的酒精使用障碍康复者睡眠障碍干预措施

• 批准号: 9909547
• 负责人: Ellen Frank
• 金额: $ 25.06万
• 依托单位: HEALTH RHYTHMS, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2020-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9909547
• 关键词: Abstinence; Address; Affect; American; Anxiety; Behavior; Behavior Therapy; Behavior monitoring; Behavioral; Cellular Phone; Circadian Rhythms; Clinical; Cognitive Therapy; Complex; Cues; Data; Development; Education; Environment; Family; Feedback; Follow-Up Studies; Funding; Goals; Grant; Health; Healthcare; Heart Diseases; Hygiene; Hypertension; Individual; Intervention; Interview; Measurement; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Mental disorders; Mission; Modeling; Monitor; Outcome; Participant; Pathway interactions; Patients; Personal Satisfaction; Phase; Polysomnography; Population; Productivity; Qualitative Methods; Randomized Controlled Trials; Recovery; Regulation; Relapse; Rest; Risk; Risk Factors; Role; Series; Severities; Sleep; Sleep Disorders; Sleep disturbances; Sleeplessness; Small Business Innovation Research Grant; Structure; Surveys; Technology; Telephone; Testing; Treatment outcome; Universities; Utah; Work; addiction; alcohol abstinence; alcohol use disorder; base; behavioral health; cost; depressive symptoms; drinking; efficacy testing; experience; immune function; improved; indexing; interest; intimate behavior; member; mobile application; mobile computing; patient population; personalized intervention; primary outcome; psychoeducation; psychoeducational intervention; reduce symptoms; relapse risk; secondary outcome; sensor; smartphone Application; social; welfare

The most recent national surveys indicate that alcohol use disorders adversely affect the well-being, work productivity, financial welfare and families of at least 15 million Americans. Every year a very substantial proportion of the individuals who suffer from alcohol use disorder (AUD) attempt to stop drinking, but somewhere between 40 and 60% will relapse within the first three months. One of the most consistent correlates of early recovery is sleep problems. Importantly, these sleep problems constitute a major risk factor for relapse. While some efforts have been made to address this critical risk factor through targeted interventions, to date these efforts have been limited to small populations of patients and have yet to receive broad dissemination. HealthRhythms, Inc. (www.healthrhythms.com) was founded in 2014 with the goal of using mobile technology to add the layer of behavioral health care to all of healthcare. Our product model capitalizes on the ubiquity and intimacy of smartphones and their capacity to sense parameters of behavior that represent key indicators of behavioral health on a 24/7 basis that are captured in the user’s natural environment. We then build on that measurement to create highly personalized interventions for mental and addictive disorders with a particular focus on sleep/wake and rest/activity regulation. Through our initial SBIR funding, we have built and are currently validating Cue®, a mobile intervention app aimed at regularizing sleep/wake and other behavioral rhythms as a means of ameliorating symptoms of depression and anxiety. We now propose to adapt Cue® to the specific needs of individuals with AUD in early recovery who are experiencing difficulties with sleep. The product we envision will ultimately have three major components: 1) automatic behavioral monitoring via the sensors on the smartphone, 2) psychoeducation about sleep and the complex relationship between sleep and AUD and 3) personalized intervention based on the principles of cognitive behavioral treatment for insomnia (CBT-I) and built upon the individual user’s sensed behavioral profile. The Specific Aims of this Fast Track application are: PHASE I - Aim 1: Achieve a better understanding of the specific sleep difficulties experienced by individuals with AUD who are in the early recovery phase (the first six months of attempted abstinence). Aim 2: Based on the data obtained in these interviews, create a Beta version of the proposed intervention, tentatively called, CueToSleep. PHASE II - Aim 3: Beta test CueToSleep and, based on user feedback, prepare the final version of the app for an adequately-powered RCT. Aim 4: Test the efficacy of CueToSleep in comparison to monitoring alone in terms of its ability to improve sleep and diminish the risk of relapse and examine moderators and mediators of treatment outcome.

最新的全国性调查表明，酒精使用障碍对幸福感、工作效率、经济状况 福利和至少1500万美国人的家庭。每年都有相当大比例的人遭受 患有酒精使用障碍(AUD)的人试图戒酒，但40%到60%的人会在第一次戒酒后复发 三个月。影响早期康复的最一致的因素之一是睡眠问题。重要的是，这些睡眠问题 构成复发的主要风险因素。虽然已经做出了一些努力来解决这一关键风险因素，但有针对性的 尽管采取了干预措施，但迄今为止，这些努力仅限于少数患者，尚未得到广泛传播。 HealthRhythms，Inc.(www.Health thhythms.com)成立于2014年，目标是使用移动技术来添加层 将行为健康护理推广到所有医疗保健领域。我们的产品模式利用了智能手机的无处不在和亲密性，并 他们能够全天候感知代表行为健康关键指标的行为参数 在用户的自然环境中。然后，我们在该测量的基础上为心理健康创建高度个性化的干预措施 以及成瘾障碍，特别关注睡眠/清醒和休息/活动调节。通过我们最初的SBIR资金，我们 我已经构建并正在验证Cue®，这是一款旨在规范睡眠/醒来和其他行为的移动干预应用 节奏作为一种改善抑郁和焦虑症状的手段。我们现在建议调整CUE®以满足特定需求 处于早期恢复期的澳门氏症患者中有睡眠困难的。我们设想的产品最终将 有三个主要组成部分：1)通过智能手机上的传感器进行自动行为监控，2)关于 睡眠及睡眠与AUD的复杂关系；3)基于认知原理的个性化干预 失眠行为治疗(CBT-I)，建立在个人用户感知的行为配置文件基础上。的具体目标 这个Fast Track应用程序是：阶段I-目标1：更好地了解所经历的具体睡眠困难 处于早期康复阶段(尝试戒酒的前六个月)的澳门氏症患者。目标2：基于 在这些采访中获得的数据创建了拟议干预措施的Beta版本，暂定为CueToSept。相位 II-目标3：测试版CueToSept，并根据用户反馈，准备该应用程序的最终版本，以获得足够的动力 RCT。目标4：就改善睡眠和改善睡眠的能力而言，测试CueToSept与单独监测的有效性 减少复发的风险，并检查治疗结果的调解人和调解人。