Tele-Sleep Decision Assist Tool
Sleep management is a high priority of the military to optimize Warfighter performance, remain safe, and potentially, reduce the likelihood of psychological issues downstream. Personnel with sleep deprivation are likely to perform at a suboptimal state, both mentally and physically, which jeopardizes themselves, their companions, the mission, and the general effectiveness of the military unit.
According to the National Sleep Foundation, “85% of active duty Service members have been diagnosed with a sleep disorder, such as sleep apnea or insomnia.” Studies have also shown that up to 40% of returning personnel have sleep disorders that can lead to depression and anxiety, as well as contribute to other medical disorders, such as cardiovascular disease, high blood pressure, and diabetes.
Currently, behavioral sleep interventions are recommended as the first-line of treatment of such sleep disorders, such as relaxation training, stimulus control therapy, sleep hygiene, etc., and many have shown improvements in patient outcomes in the clinic. However, the success of many of these therapies is limited due to: i) an insufficient number of clinicians and sleep clinics specializing in behavioral sleep interventions; ii) a large number of patients seeking treatment (high demand, low supply), and iii) a current practice that relies on multiple visits of face-to-face sessions with the clinician to reach an acceptable patient outcome. The time commitment, travel, inconvenience and general lack of trained practitioners contributes to the limited accessibility of these valuable interventions and leaves many patients with untreated sleep disorders.
In addition to advocating for a cultural change toward improved sleep practices, the military is focused on scaling-up the availability of behavioral sleep intervention services to relieve the growing pressure on its workforce and assist in the physiological and psychological restoration of active-duty personnel prior to redeployment or transition into the civilian workforce as veterans.
As a result, this MTEC program focuses on the transition of evidenced-based behavioral sleep interventions for application to the military population to address the aforementioned limitations of current practices. A solution is required that reduces time commitment, minimizes travel, eliminates inconvenience, and enables practitioners not specialized in behavioral sleep intervention to provide treatment. To accomplish this objective, MTEC has issued two awards to:
- Develop a “telehealth” device or alternative means (such as an “app”) that provides scalable behavioral sleep intervention methods to a military-relevant population.
- Conduct a clinical study that demonstrates the potential of the “telehealth” device or alternative means (developed in Task 1) to provide behavioral sleep intervention to a military-relevant patient population.
The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (19-02-Tele-Sleep).
Title of Project: Optimizing the Scalability of Evidence-Based Behavioral Sleep Medicine Practices with Noctem
Project Team: Rehat LLC, Naval Health Research Center Sleep and Fatigue Research, University of Pittsburg
Award Amount: $ 1,999,997
Project Duration: 2 years
1) To advance the capabilities and functions of a mobile health (mHealth) system, NOCTEM, which provides scalable behavioral sleep intervention methods to military-relevant populations by:
- Maximizing ts scalability and usability by non-sleep experts by further refining the detection and intervention algorithms;
- Developing algorithms using data extracted from wearable sensors to detect sleep disordered patterns and enhance therapeutic precision; and
- Initiating efforts to establish a roadmap and strategies for inter-operability with MHS Genesis.
2) To conduct a randomized effectiveness-implementation trial:
- Quantify the magnitude of improvements in insomnia and overall sleep quality in patients who receive sleep care with NOCTEM; and
- Examine and compare the reach, adoption, and sustainability of NOCTEM without or with external facilitation (EF) or with EF and internal facilitation (EF/IF) in military treatment facilities and Clinics within Navy Medicine West.