PROJECT SUMMARY
This K23 award will support the candidate’s training and development towards an independent clinical
research career focused on behavioral sleep medicine and the use of remote technology-based
delivery/assessment of mindfulness meditation (MM) to facilitate self-sleep management in patients with
chronic insomnia disorder. BACKGROUND. Insomnia is highly prevalent and associated with a wide range of
deleterious health consequences. According to well-established disease models, insomnia is characterized by
bedtime stress, pre-sleep hyperarousal, or high sleep reactivity. MM is a promising intervention for patients
with insomnia. The delivery of MM via mobile health has largely increased access to such interventions.
Technology has allowed both remote delivery of intervention and home assessment with physiological
recordings that increase access to real-world data. Existing studies have mostly focused on daytime MM
practice and subjective sleep quality at night. It is not clear whether the temporal relationship of bedtime MM
practice is important to sleep outcomes, what is the most effective way to deliver app-based MM for patients
with insomnia disorder, or whether physiological changes correlated with mindfulness practice contribute to
sleep improvement. SPECIFIC AIMS. This K23 proposes a proof-of-concept feasibility study with aims to: (1)
refine content delivery of an app-based MM intervention (specifically for bedtime use); (2) evaluate the
feasibility and acceptability of the app-based intervention in a pilot randomized controlled trial; and (3) explore
patterns of change in sleep-related subjective/objective outcomes, including remote assessment. TRAINING.
To develop expertise critical to the candidate’s overall career goals, Dr. Ma will receive training in three areas:
(1) behavioral sleep medicine and clinical trials; (2) qualitative and mixed methods research; and (3) mobile
health (mHealth), technology-based sleep interventions and assessment. These training aims will be supported
by strong institutional resources, as well as coursework, trainings, research seminars/meetings, and scientific
conferences. MENTORSHIP. The candidate will be supported by an expert mentoring team including primary
mentors Janet Mullington, PhD and Gloria Yeh, MD, MPH, co-mentor/collaborators Peter Wayne, PhD,
Suzanne Bertisch, MD, MPH, Ana-Maria Vranceanu, PhD, John Torous, MD, MBI, Pamela Rist, ScD, and
Karen Kilgore, PhD. IMPACT. Findings from the pilot study will inform the design of a larger trial and form the
necessary foundation to further investigate mobile-health MM approaches for insomnia disorder and
understand links between pre-sleep MM and sleep quality. Building on the candidate’s existing skills in
physiological signal analysis, this K23 award will allow the candidate’s development as a clinical/translational
researcher with expertise in mobile technology-based MM intervention and assessment for management of
sleep, and complex physiological signals to elucidate the effects of MM on sleep.