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Solving insomnia electronically: Sleep treatment for asthma (SIESTA): A study protocol for a randomized controlled
Xiaojun Shi1, Daniel J Buysse2, Lee M Ritterband3
1School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States of America.
Contemporary Clinical Trials
|March 3, 2019
Summary
Cognitive-behavioral treatment for insomnia (CBT-I) can improve sleep and asthma control in adults with both conditions. This study investigated CBT-I
Area of Science:
- Pulmonary Medicine
- Sleep Medicine
- Behavioral Science
Background:
- Chronic insomnia frequently co-occurs with poorly controlled asthma.
- Cognitive-behavioral treatment for insomnia (CBT-I) is effective for insomnia in other medical conditions.
- The impact and mechanisms of CBT-I on asthma control remain unexamined.
Purpose of the Study:
- To evaluate the efficacy of an internet-based CBT-I program for improving sleep and asthma control in adults with insomnia and asthma.
- To explore airway inflammation markers (exhaled nitric oxide, blood eosinophils) as potential mediators linking sleep and asthma improvements.
Main Methods:
- A single-center, parallel-group randomized controlled trial involving 210 adults with insomnia and uncontrolled asthma.
- Participants were randomized to a 9-week internet-based CBT-I program (SHUTi) or enhanced usual care (online educational video).
- Outcomes including insomnia severity, sleep quality, asthma control, and airway inflammation were assessed at baseline, 9 weeks, and 6 months.
Main Results:
- Primary outcome: reduction in insomnia severity.
- Secondary outcomes: improvements in sleep quality, asthma control metrics (Asthma Control Test, AQLQ, PFTs), and reduced asthma exacerbations.
- Exploration of biological mechanisms including exhaled nitric oxide and blood eosinophils.
Conclusions:
- This trial may reveal a new approach to enhance asthma management by addressing comorbid insomnia.
- Positive findings could support integrating insomnia treatment into asthma care guidelines.
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