Center for Innovation in Sleep Self-Management (CISSM)

Ward, Teresa; Heitkemper, Margaret

Abstract

? OVERVIEW The mission of the Center for Innovations in Sleep Self-Management (CISSM) is to advance nursing science through the development, testing, and implementation of self-management interventions that use technology to assist adults and children with chronic illnesses to sleep better and simultaneously improve health, well-being, and quality of life. Sleep deficiency (e.g., as in disrupted sleep, an inadequate amount of, or poor quality sleep) is common in chronic illness and directly contributes to decrements in daytime function, health related quality of life, increased health care utilization,1,2 and is associated with increased morbidity and mortality.3,4 Often adults and children with chronic illness, who report poor quality of life, also have significant sleep deficiency.5 Self-management intervention programs have been developed, tested and disseminated for specific chronic illnesses such as diabetes,6 arthritis, HIV and back pain.7 Cognitive behavioral therapies (CBT) for insomnia are effective for improving sleep in older adults with osteoarthritis with insomnia and pain.8 However, few of these studies incorporated new mobile technologies both to monitor self-management skills and symptoms to address sleep deficiency, which is ubiquitous in chronic illnesses. Use of new mobile technologies will facilitate the ability of individuals to self-monitor and visualize their sleep, symptoms, and behavioral data and aid them in taking appropriate actions on potentially a daily basis. Development of effective sleep self-management interventions that use technology will empower patients and their caregivers and has the potential to improve health and health care outcomes of individuals living with a chronic illness. Building on the success of the previous University of Washington Center for Research on the Management of Sleep Disturbances (UW-CRMSD, 2009-2014), the overall goal for the new CISSM is to provide research resources to assist new and early career stage investigators to develop expertise in designing, testing, and disseminating self-management interventions that integrate technology to improve sleep and impact health and health care outcomes in the context of chronic illnesses. The innovation of CISSM is the development of technology-assisted sleep self-management interventions.
The aims of the CISSM are to: 1) Expand the number of new and early career stage nursing investigators conducting research on self- management interventions that use technology to improve sleep and daytime function in individuals living with a chronic illness. 2) Leverage existing and develop new resources and instruments for data sharing across studies, and integrate common data elements specific to self-management research into the Pilot Projects. 3) Integrate existing and design new technologies that increase the ability of individuals to self-manage their sleep with the goal of improving health outcomes. 4) Promote interdisciplinary collaborations specific to sleep self-management in adults and children with chronic illness. The previous UW-CRMSD created a solid infrastructure and interdisciplinary scholarly environment that provides the foundation for a focused area of sleep self-management research. Within the CISSM, we will strengthen and expand the existing infrastructure with a new emphasis on informatics and patient-centered technology tools. Two pilot projects are included with this application and the Principal Investigators are a new investigator (Sonney) and an early career stage investigator (Zaslavsky). The Pilot Projects were selected from a pool of potential applications based on the congruency of the project aims with the CISSM themes. Measures of common data elements (CDEs) for sleep deficiency, daytime function and health outcomes (e.g. PROMIS sleep disturbance, pain, global health) and the self-management intervention components (e.g. self-efficacy, motivation, patient activation) are consistent with the CISSM's conceptual framework and integrated with other measures appropriate for the specific population and chronic illness focus of the pilot project. The CISSM environment will provide the Pilot Project Investigators with ample interdisciplinary resources and mentorship from agencies inside the UW (Interdisciplinary Translational Health Science [ITHS; name of UW-CTSA], Center for Outcomes Research in Rehabilitation (UWCORR), Center for Informatics and Patient-Centered Technology (CIPCT), Human Design Center and Engineering (HDCE), and affiliated with the UW (Seattle Children's Research Institute [SCRI], and Seattle Children's Hospital (SCH), as well as the community (EraLiving). The Center includes three cores: 1) Administrative (AC), 2) Pilot Project (PPC); and 3) Informatics and Patient Centered-Technologies (IPCT) Core. Continued identification and mentorship of new investigators is viewed as critical to the success and sustainability of innovative sleep self-management strategies and research at the UW. The University and UW School of Nursing (SoN) will provide financial support for 3 additional Pilot Projects over the 5-year period. We will use the NINR Center Directors' logic model to evaluate the Center's progress, outcomes, and to ensure sustainability.9

Public Health Relevance

PROJECTIVE NARRATIVE Across the lifespan, sleep deficiency is common in chronic illness and directly contributes to decrements in daytime function, health related quality of life, increased health care utilization, and is associated with increased morbidity and mortality. Efforts to target the development and testing of self-management interventions to assist adults and children to obtain adequate, good quality sleep are timely, important, and address a clinical problem for those living with a chronic illness.