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.

Public Health Relevance

Sleep disturbance is a significant health problem that contributes to fatigue, depression, cognitive impairment, and diminished quality of life in individuals with multiple sclerosis (MS). Effective and accessible treatments for sleep disturbance in MS are greatly needed. This project proposes to develop and evaluate an innovative, internet-delivered cognitive behavioral intervention for sleep disturbance in MS.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD086154-02
Application #
9352698
Study Section
Special Emphasis Panel (CHHD1-K)
Program Officer
Quatrano, Louis A
Project Start
2016-09-13
Project End
2021-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
2
Fiscal Year
2017
Total Cost
$126,531
Indirect Cost
$9,187
Name
Johns Hopkins University
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Hughes, Abbey J; Dunn, Katherine M; Chaffee, Trisha et al. (2018) Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis. Arch Phys Med Rehabil 99:2045-2049