ABSTRACT
Objectives
Study objectives were to: 1) iteratively adapt the Transdiagnostic Sleep and Circadian Intervention (TranS-C) for patients in cardiac rehabilitation (CR; Phase 1) and 2) conduct a preliminary single group pre-post intervention test to a) evaluate procedural feasibility and intervention acceptability and b) to explore preliminary pre-post changes in self-reported sleep, disability, and health-related quality of life (HRQoL; Phase 2).
Method
In Phase 1, 12 individuals in CR and six content experts completed interviews to inform TranS-C adaptations. Interviews were analyzed using rapid qualitative analysis. In Phase 2, eight individuals in CR completed a baseline assessment, the adapted TranS-C intervention, and a post-intervention assessment. Intervention acceptability was assessed via questionnaire and interview. Sleep, disability, and HRQoL outcomes were assessed using questionnaires. Descriptive statistics were calculated for quantitative measures; interviews were analyzed using rapid qualitative analysis.
Results
Phase 1 participants were receptive to the premise and structure of the adapted intervention. In Phase 2, participants endorsed positive attitudes toward the intervention. Seven of eight participants demonstrated improvements in sleep outcomes. Disability and HRQoL results did not consistently improve.
Conclusion
The adapted TranS-C intervention was acceptable to CR patients and could yield improvements in subjective sleep outcomes. Larger-scale testing in CR is warranted.
Acknowledgments
The authors would like to express our sincere gratitude to the study participants and clinical staff. We would also like to express our appreciation for Dr. Jon Walker, who assisted in creation of the study database. The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs or the United States Government. Because several of the authors of this manuscript are employees of the U.S. Government and contributed to this manuscript as part of their official duties, the work is not subject to US copyright.
Disclosure statement
Ms. Phares, Dr. Tighe, Dr. Weiner, Dr. Beehler, Dr. VanSwearingen, Dr. Hilgeman, and Dr. Forman have no conflicts to report. Dr. Harvey has received book royalties from the American Psychological Association, Guilford Press, and Oxford University Press. Over the past 3 years, Dr. Buysse has served as a paid or unpaid consultant to the following: National Cancer Institute, Pear Therapeutics, Sleep Number, Idorsia, Eisai. All consulting agreements have paid a total of less than $5000 per year from any single entity. Dr. Buysse is an author of the Pittsburgh Sleep Quality Index, Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A), Brief Pittsburgh Sleep Quality Index (B-PSQI), Daytime Insomnia Symptoms Scale, Pittsburgh Sleep Diary, Insomnia Symptom Questionnaire, and RU_SATED (copyrights held by University of Pittsburgh). These instruments have been licensed to commercial entities for fees by the University of Pittsburgh; Dr. Buysse receives a portion of the licensing fees. He is also co-author of the Consensus Sleep Diary (copyright held by Ryerson University), which is licensed to commercial entities for a fee by Ryerson University; Dr. Buysse receives a portion of the licensing fees.
Data availability statement
Limited data available on request due to privacy/ethical restrictions.