Sleep health in special populations

项目总结 这项续期申请的目的是为培训学员和初级调查人员在 睡眠障碍和睡眠健康领域的患者谁处于“风险”。申请人的当前身份 研究项目的重点是治疗未被研究的人群中的睡眠障碍 从目前的循证干预中获益较少。这个项目提供了丰富的机会 让受训者直接参与以患者为中心的睡眠研究。目前资助的工作重点是 对患有失眠障碍和创伤后应激障碍(PTSD)的退伍军人 失眠的认知行为疗法(CBT-I)比个人更难被接受和有效 没有创伤后应激障碍。基于新出现的证据表明， 接受与承诺疗法(ACT)结合使用可为改善睡眠提供一种可行的方法 基于证据的行为策略，一种新的基于ACT的失眠治疗，称为“接受和 行为改变治疗失眠症(ABC-I)正在进行临床试验。ABC-I结合了核心行为 采用基于ACT的技术的组件(睡眠限制、刺激控制、睡眠卫生、放松)将是 在随机试验中进行评估。使用比较有效性设计(n=200随机到ABC-I或 失眠的认知行为疗法(CBT-I)，该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(非自卑)和PTSD症状(优势)方面效果显著。 其他目标涉及从治疗前到治疗后的潜在变化机制，并探索潜在的 在减少其他症状方面的辅助好处。拟议的分析计划将同时处理 ABC-I在改善创伤后应激障碍症状方面优于CBT-I，且ABC-I与CBT-I相比不逊色 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，这项研究 为学员提供丰富的机会，从事以患者为导向的睡眠障碍研究的各个方面， 包括与研究参与者的直接互动以及参与数据分析和传播 调查结果。加州大学洛杉矶分校和VAGLAHS的研究环境充满了学习和 睡眠健康和睡眠障碍领域的协作式辅导。在前K-K期间活动的基础上- 24获奖，申请者将参加正式的领导力培训并获得领导力的支持 发展局。

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.