New grant awarded to Dr Megan Crawford and Dr Leanne Fleming from the School of Psychological Sciences and Health in September 2020.
Title: Digital Cognitive Behavioural Therapy for Insomnia in Chronic Migraines: Feasibility of a Randomised Controlled Trial. PI Dr Megan M Crawford; Co-Is, Dr George Gorrie and Dr Mona Sani-Ghadiri (NHS Greater Glasgow & Clyde) and Dr Leanne Fleming.
Funded by: Brain Research UK, award £200,000; 2021-24
Chronic migraine (CM) is a debilitating condition that costs the NHS about £150 million per year. Previous research has shown that insomnia is a risk factor for migraines. Our group has hypothesised that two modifiable behaviours explain this relationship between insomnia and migraines: daytime napping and nocturnal light exposure. To cope with the migraines, individuals will nap, which can reduce the drive for sleep at night. Exposure to evening bright light, potentially because of the inability to fall asleep, can delay the release of melatonin and reduce sleep quality. Poor sleep in turn is a trigger for migraines. We believe that these behavioural mechanisms are valid targets and they are explicity addressed in Cognitive Behaviour Therapy for insomnia (dCBT-I). Our group has demonstrated the feasibility of reducing insomnia and migraine symptoms using digital CBT-I (dCBT-I). Digital CBT-I may be particularly appealing for individuals with chronic migraines, since it adds no additional burden associated with health care visits. In our proof of concept trial, we established feasibility, acceptability and preliminary efficacy of dCBT-I. We would like to extend this line of research by using a randomised control trial (RCT) design to evaluate more rigorously dCBT-I and to probe mechanism of change. Since the uncontrolled proof of concept study was conducted in a self-selected, digitally literate sample in the US, there is a need for a feasibility RCT at this stage, to refine our methodology in a UK sample with migraine patients prior to progressing to full-scale trial. We propose to recruit individuals who meet criteria for CM and insomnia directly referred from two neurology clinics, which will act as clinical recruiters. Eighty participants will be randomised either to a dCBT-I group or to sleep hygiene education (SHE, control group). The main outcomes will be collected at post-treatment, and long-term effects will be assessed after 3, and 6 months follow-up.