Hypnosis to improve sleep in menopause: Determination of optimal dose and method

催眠改善更年期睡眠：最佳剂量和方法的确定

• 批准号: 8851523
• 负责人: Gary R Elkins
• 金额: $ 20.83万
• 依托单位: BAYLOR UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8851523
• 关键词: Address; Adherence; Adverse effects; Adverse event; Affect; Age; American; Cardiovascular Diseases; Clinical Trials; Collaborations; Data; Diabetes Mellitus; Dose; Dropout; Emergency department visit; Endogenous Factors; Enrollment; Environment; Ethnic Origin; Exogenous Factors; Goals; Health; Healthcare; Home environment; Hot flushes; Hour; Human Resources; Hypnosis; Intervention; Knowledge; Laboratories; Life; Link; Measurement; Measures; Menopausal Status; Menopausal Symptom; Menopause; Methods; Morbidity - disease rate; National Center for Complementary and Alternative Medicine; Pain; Participant; Patient Self-Report; Pharmaceutical Preparations; Postmenopause; Prevalence; Productivity; Public Health; Quality of life; Questionnaires; Race; Randomized Clinical Trials; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Research Design; Risk; Severities; Site; Sleep; Sleep Disorders; Sleep disturbances; Sleeplessness; Socioeconomic Status; Staging; Symptoms; Testing; Treatment Protocols; Woman; Work; Wrist; actigraphy; alternative treatment; design; diaries; hormone therapy; improved; innovation; malignant breast neoplasm; middle age; mortality; obesity risk; post intervention; primary outcome; programs; public health relevance; satisfaction; secondary outcome; statistics; success; trend

DESCRIPTION (provided by applicant): Poor sleep is among the most frequent, yet least addressed, health concern among women during the menopause transition and the prevalence of poor sleep increases with age. In addition, poor sleep has been associated with increased risks for other health problems, adverse effects of prescription sleep medications, and mortality; affecting the quality of life and health of midlife women. Our laboratory has identified that hypnosis, when delivered with five (5), therapist delivered, individualized hypnosis inductions can improve self- reported sleep quality among postmenopausal women presenting with a primary complaint of hot flashes. However, as currently developed, hypnosis is labor intensive and not easily disseminable, thus, limiting its potential public health impact. If a hypnosis program could be developed that is less personnel-intensive and more easily disseminable, it could have a large public health impact on the sleep of midlife women. In addition, the potential impact of any hypnosis program on objectively measured sleep has not yet been examined and there is little data for effect size estimates. Our long range goal is to identify a safe, efficacius, and widely disseminable hypnosis intervention for the treatment of sleep problems during the menopause transition. The purpose of this application is to determine the optimal dose and delivery method for a hypnosis program that shows feasibility, acceptable adherence, and preliminary effects on sleep (primary outcomes) and other secondary outcomes (sleep quality, insomnia symptom severity, daytime sleepiness, menopausal symptoms, and pain). We will enroll 80 menopausal women into a 2X2 factorial design to compare two dosing (three vs. five sessions) and two delivery methods of hypnosis (audio recorded vs. therapist delivered inductions) with assessments at baseline and four, six, and eight weeks post-intervention. Specific aims are to (1) Determine the feasibility of and adherence to the four hypnosis programs; (2) Determine initial effect sizes for the primary outcome of objectively measured sleep duration, including the percent of women who achieve a clinically meaningful improvement; (3) Determine initial effect sizes for secondary outcomes of sleep quality, insomnia symptom severity, daytime sleepiness, menopausal symptoms, and pain; and (4) Trends in potential covariates including endogenous factors (e.g., age, race/ethnicity, menopausal stage) and exogenous factors (e.g., sleep environment, socioeconomic status). Statistical analysis will determine feasibility (< 25% dropout; rating of "good" or better for the program, and <5% adverse events) and adherence (> 75% compliance with daily at-home practice). Estimated effect sizes for primary and secondary outcomes will be calculated using standard methods and the optimal programs identified (e.g., a >b>c>d). Trends in potential covariates will be analyzed using Pearson correlations for continuous covariates (e.g., age), and for categorical covariates (e.g., demographic/environment variables) t tests or ANOVAs will be conducted, as appropriate. Findings will provide the requisite data to plan a subsequent R01 application for a multi-site, large-scale, randomized controlled trial.

描述（由申请人提供）：睡眠不佳是更年期过渡期间女性最常见但最少解决的健康问题之一，睡眠不佳的患病率随着年龄的增长而增加。此外，睡眠不佳还与其他健康问题的风险增加、处方安眠药的副作用和死亡率增加有关。影响中年妇女的生活质量和健康。我们的实验室已经发现，当五 (5) 名治疗师进行个性化催眠诱导时，可以改善以潮热为主要主诉的绝经后妇女的自我报告睡眠质量。然而，就目前的发展而言，催眠是劳动密集型的，并且不易传播，因此限制了其潜在的公共健康影响。如果能够开发出人员较少且更容易传播的催眠计划，则可能会对中年女性的睡眠产生巨大的公共卫生影响。此外，任何催眠计划对客观测量的睡眠的潜在影响尚未得到检验，并且几乎没有关于效果大小估计的数据。我们的长期目标是找到一种安全、有效且可广泛传播的催眠干预方法，用于治疗更年期过渡期间的睡眠问题。本申请的目的是确定催眠计划的最佳剂量和实施方法，该计划显示出可行性、可接受的依从性以及对睡眠（主要结果）和其他次要结果（睡眠质量、失眠症状严重程度、白天嗜睡、更年期的影响）的初步影响。症状和疼痛）。我们将招募 80 名更年期女性进行 2X2 析因设计，以比较催眠的两种给药方式（3 次与 5 次）和两种催眠实施方法（录音催眠与治疗师实施的诱导），并在基线和术后 4、6 和 8 周进行评估-干涉。具体目标是 (1) 确定四种催眠方案的可行性和依从性； (2) 确定客观测量的睡眠时间主要结果的初始效应大小，包括实现临床有意义的改善的女性百分比； (3) 确定睡眠质量、失眠症状严重程度、白天嗜睡、更年期症状和疼痛等次要结果的初始效应大小； (4) 潜在协变量的趋势，包括内源性因素（例如年龄、种族/民族、更年期阶段）和外源性因素（例如睡眠环境、社会经济地位）。统计分析将确定可行性（< 25% 的退出率；该计划的评级为“良好”或更好，以及 <5% 的不良事件）和依从性（> 75% 的日常家庭实践依从性）。主要和次要结果的估计效应大小将使用标准方法和确定的最佳方案进行计算（例如，a>b>c>d）。将使用连续协变量（例如年龄）的皮尔逊相关性来分析潜在协变量的趋势，对于分类协变量（例如人口/环境变量），将酌情进行 t 检验或方差分析。研究结果将为规划后续 R01 多中心、大规模、随机对照试验的应用提供必要的数据。