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

哮喘是一种流行的慢性呼吸道炎症性疾病，与一系列不利健康有关。 结果。失眠是哮喘患者的常见症状。它通常被视为是 哮喘相关的夜间觉醒，这将在适当控制哮喘的情况下解决。然而，我们的前辈 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(即共病)中也是如此 失眠)。失眠可能通过肺功能减退等机制与哮喘控制有关 功能和炎症增加。因此，针对失眠的靶向治疗可能是一种新的治疗方法。 改善哮喘控制和哮喘相关生活质量。互联网是交付以下服务的可行选择 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治疗共病失眠的适用性尚不清楚。中心假说 建议的研究结果是，互联网是一种可行且可接受的方法，可以为患有以下疾病的成年人提供CBT-I 哮喘和共病失眠。拟议研究的主要目的是：1)评估可行性和 基于互联网的CBT-I，使用互联网睡眠健康(SHUTI)，对成人哮喘和 2)探讨舒体内容与哮喘相关适应的必要性。焦点小组 将用于获取参与者对哮喘相关内容的建议或其他相关内容，以适应 舒蒂程序。第二个目标是探索睡眠和哮喘结果从基线到治疗后的变化。 治疗。使用有效的、低成本的、基于互联网的CBT-I可以提供一种治疗选项，该选项可以 在现实世界的临床环境中交付。研究结果将使互联网干预的优化成为可能 并开发了一项临床试验，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.