New digital programs that provide cognitive behavioral therapy online can help improve symptoms of insomnia in those who take the program, finds a new study. The findings of this study are published in the journal of JAMA Psychiatry. Treating insomnia with digital programs can improve insomnia symptoms, daytime functioning, and overall health, a new study from the University of Oxford and Northwestern Medicine has found.
‘Online cognitive behavioral therapy (CBT) was found to improve the overall health nevertheless insomnia too’
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In a year-long study involving 1,711 people, researchers found online cognitive behavioral therapy (CBT) improved not only insomnia symptoms but functional health, psychological well-being and sleep-related quality of life.A major limitation of insomnia treatments is the lack of providers to deliver CBT, but this study used an online platform that made it easily accessible to users. It also automated and tailored the treatment based on the user's sleep patterns.
Study co-author Jason Ong said there is a four-to-six month wait for an insomnia patient to get an appointment in his sleep clinic.
"We can reach many more patients with insomnia by using a digitally based program," said Ong, associate professor of neurology in sleep medicine at Northwestern University Feinberg School of Medicine.
Insomnia has been identified as a risk factor for the development of mental health disorders, cardiovascular disease and type 2 diabetes.
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The study provides new evidence that the clinical benefits of digital CBT extend beyond sleep to also improve a person's daytime functioning.
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Though insomnia has traditionally been treated with pharmaceuticals, new guidelines published in 2016 by the American College of Physicians recommend that CBT be used first-line, ahead of sleeping pills.
Study participants received treatment using the Sleepio program and an associated iOS app. Sleepio, a digital sleep improvement program featuring CBT techniques designed by Espie, is a product of Big Health.
Delivery was structured into six sessions lasting an average of 20 minutes each, with participants having access to the intervention for up to 12 weeks. Researchers assessed the study participants online at 0 weeks (baseline), four weeks (mid-treatment), eight weeks (post-treatment), and 24 weeks (follow-up). Program content was based on CBT manuals and included behavioral, cognitive and educational components.
Additional study findings were as follows:
In the digital CBT (dCBT) group, 689 participants (80.8 percent) logged on for at least one session, 491 participants (57.6 percent) completed at least four sessions, and 413 participants (48.4 percent) completed all six sessions.
At weeks four, eight and 24, dCBT was associated with significant improvement in global health and mental wellbeing. Improvements in insomnia mediated these outcomes.
- Symptoms of depression, anxiety, sleepiness and cognitive failures all demonstrated significant differences in favor of dCBT at weeks four, eight and 24. While the degree of change was relatively small, the changes were statistically significant.
- The degree of change for fatigue was moderate to large at weeks four, eight and 24.
- Regarding productivity at work due to sleep problems, results showed a small to moderate improvement after dCBT.
- A small but significant effect in terms of reduced absenteeism attributed to poor sleep and increased job satisfaction was observed at week 24.
- There were no significant effects at any time on relationship functioning.
Source-Eurekalert