An Internet-delivered Cognitive Behavioral Intervention for Sleep Disturbance in Multiple Sclerosis

项目摘要 这个K23指导的以患者为导向的研究职业发展奖的目标是为PI（修道院J。 休斯，博士）制定一项研究计划，旨在提供创新，有效和可访问的 治疗多发性硬化症（MS）患者睡眠障碍的干预措施。睡眠障碍是一种 严重的健康问题影响着54%到67%的MS患者。睡眠障碍是其中之一， 疲劳、神经心理功能障碍、疼痛、抑郁和 虽然研究支持失眠的认知行为疗法（CBT-I）作为金标准， 治疗睡眠障碍，CBT-I尚未适应和测试在MS。因此，这五个目标- 一个为期一年的研究项目是开发和评估一个创新的，互联网提供的初步效果， 认知行为干预治疗MS睡眠障碍（iSlIMS）。建议的具体目标 项目是：1）确定iSlIMS对睡眠效率，数量和质量的初步影响; 2） 确定iSlIMS治疗满意度、依从性和完整性;以及3）确定 iSlIMS对疲劳，抑郁和神经心理功能障碍的影响。该项目将采用随机 对照试验（RCT），比较iSlIMS与常规治疗（n = 90）。确保成功 完成该项目后，PI制定了一项培训计划，包括指导研究、教学培训和 专业活动，使她能够获得：1）利用以患者为导向的结果的RCT专业知识; 2） 在MS睡眠障碍的科学测量和认知行为治疗方面的专业知识， 其他神经康复人群; 3）进行网络和移动的的基础知识和技能- 基于远程医疗干预研究;和4）精通学术演讲，手稿出版， 还有格兰比亚PI将与MS康复领域的领先专家团队合作 研究、行为睡眠医学、干预技术和药物治疗。由Dawn Ehde博士领导 （主要）和Aaron Turner（共同主要），该团队将提供指导培训，以支持PI 这个奖期。鉴于MS中睡眠障碍的巨大负担，以及MS中CBT-I的有限数据， 这一人群，拟议的研究有可能推进神经康复研究和促进 更有效的临床实践在MS和其他神经康复人群。重要的是，培训和 通过K23提案提供的研究经验将为PI提供理想的途径：1）扩展 她在临床健康心理学，神经心理学和MS康复研究方面的基础训练; 2） 完成拟议的iSlIMS研究，为更大规模的确定性试验提供信息;以及3）启动一项独立的临床研究， 研究生涯侧重于开发，批判性评估和传播创新和可访问的 临床干预，以治疗认知和行为症状，并最终改善生活质量， 个人MS

PROJECT SUMMARY The goal of this K23 Mentored Patient-Oriented Research Career Development Award is for the PI (Abbey J. Hughes, PhD) to develop a program of research aimed at providing innovative, effective, and accessible interventions for treating sleep disturbance in individuals with multiple sclerosis (MS). Sleep disturbance is a significant health problem affecting an astounding 54 to 67% of people with MS. Sleep disturbance is one of the primary contributors to fatigue, neuropsychological dysfunction, pain, depression, and diminished quality of life in MS. Although research supports cognitive behavioral therapy for insomnia (CBT-I) as the gold-standard treatment for sleep disturbance, CBT-I has yet to be adapted and tested in MS. Thus, the objective of this five- year research project is to develop and evaluate the preliminary effects of an innovative, internet-delivered cognitive behavioral intervention for sleep disturbance in MS (iSliMS). The specific aims of the proposed project are to: 1) determine the preliminary effects of iSliMS on sleep efficiency, quantity, and quality; 2) determine iSliMS treatment satisfaction, adherence, and integrity; and 3) determine the preliminary effects of iSliMS on fatigue, depression, and neuropsychological dysfunction. This project will feature a randomized controlled trial (RCT) comparing iSliMS versus treatment as usual (n = 90). To ensure the successful completion of this project, the PI has developed a training plan of mentored research, didactic training, and professional activities that will allow her to acquire: 1) expertise in RCTs utilizing patient-oriented outcomes; 2) expertise in the scientific measurement and cognitive behavioral treatment of sleep disturbance in MS and other neurorehabilitation populations; 3) foundational knowledge and skills in conducting web and mobile- based telehealth intervention research; and 4) proficiency in scholarly presentation, manuscript publication, and grantsmanship. The PI will work collaboratively with a team of leading experts in MS rehabilitation research, behavioral sleep medicine, intervention technology, and grantsmanship. Led by Drs. Dawn Ehde (Primary) and Aaron Turner (Co-primary), this team will provide mentored training to support the PI throughout this award period. Given the overwhelming burden of sleep disturbance in MS, and the limited data on CBT-I in this population, the proposed research has the potential to advance neurorehabilitation research and promote more effective clinical practice in MS and other neurorehabilitation populations. Importantly, the training and research experiences afforded through this K23 proposal will provide an ideal pathway for the PI to: 1) extend her foundational training in clinical health psychology, neuropsychology, and MS rehabilitation research; 2) accomplish the proposed study of iSliMS to inform a larger definitive trial; and 3) launch an independent clinical research career focused on developing, critically evaluating, and disseminating innovative and accessible clinical interventions to treat cognitive and behavioral symptoms and ultimately improve quality of life for individuals with MS.