The overall goal of this K23 career development award is to enhance the candidate's transition into an independent investigator of mind-body interventions for disorders of arousal. Insomnia is a highly prevalent, under-treated disorder with elevations in arousal hypothesized as a pathophysiological mechanism. Mindfulness-based interventions are short-term treatments that appear to be particularly relevant for reducing cognitive and somatic arousal, but its effects on both sleep and arousal are still not clearly understood. This proposal is a first step in the candidate's quest to answer the research question: Can a mindfulness-based intervention be used to improve the treatment of insomnia through a reduction in arousal? To this end, a program of mentored activities is proposed to enhance the candidate's research skills and professional development. Training activities will focus on five specific goals: 1) Developing expertise in mindfulness-based interventions, 2) Developing methodological skills in measures of arousal, 3) Enhancing skills in research design and analyses of clinical trials, 4) Updating training in the responsible conduct of research, and 5) Updating training in Behavioral Sleep Medicine. Building upon these training activities, the research plan aims to compare mindfulness-based stress reduction (MBSR), behavior therapy for insomnia (BT), and Mindfulness-Based Therapy for insomnia (MBT) on measures of cognitive and somatic arousal as well as subjective and objective measures of sleep. This pilot trial will serve as preliminary evidence to determine the relative effects of the three treatments and the most appropriate measures of arousal that will guide the design of a full-scale clinical trial. Together, the skills acquired through this program of mentored activities will prepare the candidate to compete for external funding and to stimulate future research aimed at improving mind-body treatments for insomnia. The ultimate goal of the candidate's program of research is to develop an empirically-based model for the psychological and physiological mechanisms of mindfulness-based interventions that can be used to train health care professionals in the treatment of insomnia. The desired outcome is to reduce the public burden of insomnia by improving non-pharmacological treatments and increasing the number of qualified treatment providers.
