Sleep health in special populations

项目摘要 此更新应用程序的目标是为培训学员和初级调查员提供指导支持， 睡眠障碍和睡眠健康领域的患者人群谁是“风险”。申请人目前 研究计划的重点是治疗睡眠障碍的人群谁没有被研究或谁 从目前的循证干预措施中获益较少。该计划提供了丰富的机会 让学员体验直接参与以患者为导向的睡眠研究。目前资助的工作重点 患有失眠症和创伤后应激障碍（PTSD）的退伍军人， 失眠症的认知行为疗法（CBT-I）比个体治疗更难接受， 没有创伤后应激障碍根据新出现的证据， 接受和承诺疗法（ACT）提供了一种可行的方法来改善睡眠， 循证行为策略，一种新的ACT为基础的失眠治疗，称为“接受和治疗”。 行为改变治疗失眠（ABC-I）正在临床试验中进行测试。ABC-I结合了核心行为 成分（睡眠限制，刺激控制，睡眠卫生，放松）与ACT为基础的技术将 在随机试验中进行评估。使用比较有效性设计（n=200例随机分配至ABC-I或 失眠的认知行为疗法（CBT-I）），研究的主要目的是评估 与CBT-I相比，ABC-I在降低失眠严重程度（非劣效性）和PTSD症状（优效性）方面。 其他目的是解决从治疗前到治疗后变化的潜在机制，并探索潜在的 在减少其他症状方面的辅助益处。拟议的分析计划将同时解决 ABC-I在改善PTSD症状方面优于CBT-I，且ABC-I非劣效于CBT-I 用于改善失眠症状。除了其他正在进行和最近完成的项目外， 为学员提供了丰富的机会，参与以患者为导向的睡眠障碍研究的各个方面， 包括与研究参与者直接互动，参与数据分析和传播， 调查结果。在加州大学洛杉矶分校和VAGLAHS的研究环境是丰富的学习机会， 睡眠健康和睡眠障碍领域的协作指导。在前一个K期间的活动基础上， 24奖，申请人将从事正式的领导培训，并从事一个领导的支持 发展理事会。

PROJECT SUMMARY The goal of this renewal application is to provide support for mentoring of trainees and junior investigators in the areas of sleep disorders and sleep health among patient populations who are “at risk.” The applicant’s current research program focuses on treatment of sleep disorders in populations who have not been studied or who have achieved less benefit from current evidence-based interventions. This program provides rich opportunities for mentees to experience direct engagement in patient-oriented sleep research. Currently funded work focuses on veterans with comorbid insomnia disorder and post-traumatic stress disorder (PTSD) for whom standard cognitive-behavioral therapy for insomnia (CBT-I) is less acceptable and less efficacious than among individuals without PTSD. Based on emerging evidence that the theoretical underpinning and specific exercises of Acceptance and Commitment Therapy (ACT) present a viable approach to improving sleep when combined with evidence-based behavioral strategies, a novel ACT-based insomnia treatment, called "Acceptance and the Behavioral Changes to Treat Insomnia (ABC-I) is being tested in a clinical trial. ABC-I combines core behavioral components (sleep restriction, stimulus control, sleep hygiene, relaxation) with ACT-based techniques will be evaluated in a randomized trial. Using a comparative effectiveness design (n=200 randomized to ABC-I or cognitive-behavioral therapy for insomnia (CBT-I)), the primary aims of the study are to evaluate the benefits of ABC-I in reducing insomnia severity (non-inferiority) and PTSD symptoms (superiority) as compared to CBT-I. Additional aims address potential mechanisms of change from before to after treatment and explore potential ancillary benefits in terms of reducing other symptoms. The proposed analytic plan will simultaneously address superiority of ABC-I over CBT-I for improving PTSD symptoms and non-inferiority of ABC-I compared to CBT-I for improving insomnia symptoms. In addition to other ongoing and recently-completed projects, the study provides rich opportunities for trainees to engage in all aspects of patient-oriented research on sleep disorders, including direct interaction with research participants and engagement with data analysis and dissemination of findings. The research environment at UCLA and VAGLAHS is rich with opportunities for learning and for collaborative mentoring in areas of sleep health and sleep disorders. Building upon activities during the prior K- 24 award, the applicant will engage in formal leadership training and engage the support of a Leadership Development Council.