Scientific Study Title:

Adapting and Evaluating an Evidence-Based Online Behavioural Intervention to Manage Insomnia in Patients with Rheumatoid Arthritis

 

Principal Investigators:

Deborah Da Costa, Scientist, Research Institute, McGill University Health Centre, Metabolic Disorders and Complications Program, Centre for Outcomes Research and Evaluation

Associate Professor, Department of Medicine, Faculty of Medicine, McGill University

Research Scientist, Arthritis Research Canada

 

Start Date:

2021

 

End Date:

2023

 

Why do this research?

Up to 70% of persons with arthritis report sleep disturbances, including difficulty falling asleep, staying asleep, and/or waking up early in the morning. These sleep disturbances, also known as insomnia, worsen other symptoms including fatigue, pain, and depression. These can negatively affect patient quality of life.

For most patients, insomnia goes unrecognized and untreated. Cognitive behavioural therapy for insomnia (CBTi) is considered first-line treatment. Studies with other patient populations indicate that it can be successfully delivered over the internet, which makes it more accessible.

No study to date has evaluated whether CBTi is an effective treatment for arthritis patients suffering with insomnia and this study fills an important and distinct gap in rheumatoid arthritis care. It will provide new knowledge on the benefits of a nondrug method for managing insomnia in patients living with rheumatoid arthritis. If found beneficial, internet delivered CBTi will help overcome barriers that prevent appropriate treatment of insomnia in rheumatoid arthritis. In turn, this will result in better management of sleep and associated clinical symptoms, improvements in quality of life, and ultimately reduced healthcare costs.

This proposal is very significant given the COVID-19 pandemic. Stress, financial burden and lifestyle changes due to social confinement are expected to have negative impacts on sleep and other mental health outcomes, particularly in populations already at risk for these difficulties.

 

What will be done?

The proposed study will first involve a Canada-wide survey with a large sample of arthritis patients to identify their sleep needs and treatment preferences. The aim of this is to better customize the internet CBTi program to arthritis.

We will then test this program to see initial evidence of its potential to improve sleep and other commonly experienced symptoms, including fatigue, pain, depression and anxiety. We expect that patients assigned to the therapy will report improvements in insomnia and other related symptoms following completion of the program. We also expect that they will maintain these improvements at the 3-month follow-up.

 

Who is involved?

Our multidisciplinary team includes experts in behavioural medicine, insomnia, rheumatology, e-health, biostatistics, and patient advisers.

 

Participants for the on-line needs assessment will be recruited to complete the 20-30 minute survey, available in French and English.

 

Co Investigators:

Diane Lacaille, MD, MHSc, FRCPC

Scientific Director, Arthritis Research Canada

Mary Pack Chair in Rheumatology Research

Professor, Division of Rheumatology, Associate Head of Academic Affairs, Department of Medicine, University of British Columbia

 

Paul R Fortin, Tenured Professor, Division of Rheumatology, Department of Medicine, Université Laval

Canada Research Chair on Systemic Autoimmune Rheumatic Diseases

Clinician-Scientist, Centre de recherche du CHU de Québec-Université Laval

Senior Scientist, Arthritis Research Canada

 

Josee Savard, PhD, Full professor, School of Psychology, Faculty of Social Sciences, Université Laval

 

Elham Rahme, PhD, Scientist, Research Institute, McGill University Health Centre, Metabolic Disorders and Complications Program, Centre for Outcomes Research and Evaluation

Associate Professor, Department of Medicine, Faculty of Medicine, McGill University

 

Carolyn Neville, RN, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Québec, Canada

 

Funding Agency:

Canadian Initiative for Outcomes in Arthritis Care (CIORA)

 

How do people get involved?

Recruitment information to follow, please check back.

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