Grant: Project Grant - PA: MSK, Skin and Oral Health: Clinical Research - MSK Health

Sleep disturbances, including difficulty falling asleep, staying asleep, and/or waking up early in the morning are all symptoms of insomnia, reported in up to 80% of persons with lupus. Importantly, sleep disturbances worsen other symptoms including fatigue, pain, and depression, all of which remain poorly managed in lupus and continue to compromise patient quality of life. For the majority of patients, insomnia goes unrecognized and untreated. Cognitive behavioural therapy for insomnia (CBTi) is considered first-line treatment for insomnia, yet no study to date has evaluated this intervention in lupus patients. The proposed study will determine whether internet delivered CBTi (ICBTi) will reduce insomnia and other commonly experienced symptoms in lupus, including fatigue, depression and pain compared to a treatment as usual control group. We expect that the lupus patients assigned to the CBTi group will report greater improvements in insomnia and other related symptoms, compared to the control group after completing the 6-week program and that these improvements will be maintained at 6-months following completion of the program. To inform the future use ICBTi as part routine lupus care for sleep management, a secondary aim of this study will be to examine patient characteristics such as sociodemographics (age, income level) and symptom severity at study entry (e.g. severity of insomnia, fatigue, pain, depression) associated with greater improvements in insomnia as a result of the 6-week program. This study fills an important gap in lupus care and will provide new knowledge on the benefits of a nondrug intervention for managing insomnia in lupus. If found to be beneficial, CBTi delivered over the internet will help overcome barriers that currently prevent appropriate treatment of insomnia in lupus care, which in turn will result in better management of sleep and associated clinical symptoms, improvements in quality of life and ultimately reduced healthcare costs.