P31 Adapting a sleep and wellbeing intervention for hashimotos thyroiditis patients with residual daytime impairment and sleepiness: a delphi study

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Mackenzie, Elizabeth and Boelaert, Kristien and Fleming, Leanne and Chan, Xavier and Crawford, Megan (2026) P31 Adapting a sleep and wellbeing intervention for hashimotos thyroiditis patients with residual daytime impairment and sleepiness: a delphi study. BMJ Open Respiratory Research, 13 (Suppl ). A34.1-A34. (https://doi.org/10.1136/bmjresp-2026-bss.54)

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Abstract

Introduction Autoimmune Hashimoto’s Thyroiditis (HT) accounts for 30% of all organ-specific autoimmune disorders worldwide, and is a leading cause for the development of hypothyroidism and the progressive failure of the thyroid gland. Although physical symptoms of the condition can be alleviated pharmacologically using Levothyroxine, it has limited success addressing psychological symptoms, namely low mood, fatigue, and excessive daytime sleepiness. This creates a basis to explore the need for a psychological intervention for patients with HT. The aim of this study is to develop a Cognitive Behavioural Therapy (CBT) protocol to be used in conjunction with current pharmacological treatment, to better support patients with their mental wellbeing and sleep. Methods To develop this protocol, we are conducting a Delphi panel of 69 experts, consisting of two groups: ‘professionals’ in endocrinology and behavioural sleep medicine (n=30), and ‘patients’ with lived experience of HT (n=39). These groups are being surveyed to advise on the development of the new CBT protocol through three iterative surveys. Results The survey process is expected to last three rounds. The first round demonstrated consensus in nine of the twelve items asked of the ‘professional’ group, requiring a consensus of 80%. Consensus was also demonstrated in six of the nine items asked of the ‘patient’ group, requiring a consensus of 75%. The survey’s second round is currently reassessing questions where consensus was not reached, and asking additional questions based on existing feedback. The third round will similarly follow. Discussion Experts at this stage agree that the protocol’s overall concept may help to support patients with HT, and will be most effective if led by adequately-trained mental health professionals. Debate on participant criteria and specificities in content and layout of the protocol are ongoing and will be realised over the coming rounds of the surveys.

ORCID iDs

Mackenzie, Elizabeth, Boelaert, Kristien, Fleming, Leanne ORCID logoORCID: https://orcid.org/0000-0001-6197-9214, Chan, Xavier ORCID logoORCID: https://orcid.org/0000-0001-9651-8063 and Crawford, Megan ORCID logoORCID: https://orcid.org/0000-0002-3167-1398;
CORE (COnnecting REpositories)