Feasibility and acceptability of an internet-based cognitive-behavioral treatment for insomnia in adults with asthma

哮喘是一种普遍存在的慢性气道炎症性疾病，与一系列不良健康状况相关 结果。哮喘是哮喘患者的常见症状。它通常被认为是一个后果， 哮喘相关的夜间觉醒，这将解决与哮喘的充分控制。但是我们的院长 研究表明失眠持续存在，即使在那些没有夜间哮喘觉醒的人中（即，共病 失眠）。哮喘的控制可能通过肺功能降低等机制， 功能和炎症增加。因此，失眠的靶向治疗可能是一种新的方法， 改善哮喘控制和哮喘相关的生活质量。互联网是一个可行的选择， 认知行为治疗失眠（CBT-I），克服了面对面CBT-I的局限性。 然而，基于互联网的CBT-I对共病失眠症的适用性尚不清楚。核心假设 建议的研究是，互联网是一个可行的和可接受的方法，提供CBT-I的成年人， 哮喘和共病失眠拟议研究的主要目的是1）评估可行性， 基于互联网的CBT-I的可接受性，使用互联网的健康睡眠（SHUTi），在成人哮喘患者中， 共病失眠和2）探讨哮喘相关适应性舒体的必要性。焦点小组 将用于获取参与者对哮喘相关或其他相关内容的建议， SHUTi程序。第二个目的是探索从基线到治疗后睡眠和哮喘结果的变化。 治疗使用一种有效的、低成本的、基于互联网的CBT-I可以提供一种治疗选择， 在现实世界的临床环境中进行。研究结果将有助于优化互联网干预 并开发一项临床试验，可以测试舒体对睡眠和哮喘结果的疗效。

Asthma is a prevalent, chronic inflammatory disease of the airways associated with a range of adverse health outcomes. Insomnia is a common complaint among those with asthma. It is often viewed as a consequence of asthma-related nocturnal awakenings, which will resolve with adequate control of asthma. Yet, our prior research suggests that insomnia persists, even in those without nighttime asthma awakenings (i.e., comorbid insomnia). Insomnia may be plausibly linked to asthma control through mechanisms such as decreased lung function and increased inflammation. Thus, targeted treatments for insomnia could be a novel approach to improving asthma control and asthma-related quality of life. The Internet is a viable option for delivery of cognitive-behavioral treatment for insomnia (CBT-I) and overcomes the limitations of face-to-face CBT-I. However, the applicability of Internet-based CBT-I for comorbid insomnia is unknown. The central hypothesis of the proposed study is that the Internet is a feasible and acceptable method to deliver CBT-I in adults with asthma and comorbid insomnia. The primary aims of the proposed study are 1) to assess the feasibility and acceptability of an Internet-based CBT-I, Sleep Healthy Using The Internet (SHUTi), in adults with asthma and comorbid insomnia and 2) to explore the need for asthma-related adaptations of SHUTi content. Focus groups will be used to obtain participants’ suggestions for asthma-related or other relevant content for adaptation of the SHUTi program. The secondary aim is to explore changes in sleep and asthma outcomes from baseline to post- treatment. The use of an efficacious, low cost, Internet-based, CBT-I can provide a treatment option that could be delivered in real-world clinical settings. Study results will enable optimization of the Internet intervention and development of a clinical trial that can test the efficacy of SHUTi on sleep and asthma outcomes.