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

最近的全国调查表明，酒精使用障碍对健康、工作生产力、财务状况 至少1500万美国人的福利和家庭。每年都有很大一部分人 酒精使用障碍（AUD）患者试图停止饮酒，但40%至60%的人会在第一次饮酒后复发。 三个月早期恢复最一致的相关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。虽然已作出一些努力，通过有针对性的措施来解决这一关键风险因素， 然而，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.healthrhythms.com）成立于2014年，目标是利用移动的技术增加图层 从行为健康护理到所有的健康护理。我们的产品模式利用了智能手机的普遍性和亲密性， 他们感知行为参数的能力，这些参数代表了24/7基础上的行为健康的关键指标， 用户的自然环境。然后，我们建立在该测量的基础上，为心理健康创造高度个性化的干预措施。 和成瘾性疾病，特别关注睡眠/觉醒和休息/活动调节。通过我们最初的SBIR资金，我们 我已经建立并正在验证Cue®，这是一款移动的干预应用程序，旨在规范睡眠/觉醒和其他行为 节奏作为改善抑郁和焦虑症状的一种手段。我们现在建议调整Cue®以满足特定需求 患有AUD的人在早期恢复谁是经历睡眠困难。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测，2）关于 睡眠和睡眠与AUD之间的复杂关系; 3）基于认知原则的个性化干预 行为治疗失眠症（CBT-I），并建立在个人用户的感知行为档案。的具体目标 这个快速通道应用程序是：第一阶段-目标1：实现更好地了解具体的睡眠困难的经验 处于早期恢复阶段（尝试禁欲的前六个月）的AUD患者。目标2：基于 在这些访谈中获得的数据，创建了一个测试版的拟议干预，暂时称为，提示睡眠。相 II -目标3：对CueToSleep进行Beta测试，并根据用户反馈，准备应用程序的最终版本，以提供足够强大的功能。 RCT。目的4：测试CueToSleep与单独监测相比在改善睡眠和睡眠质量方面的功效。 减少复发的风险，并检查治疗结果的调节因子和介导因子。

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.