Sleep is essential for your health and wellbeing, yet 10 to 12 per cent of the population suffers from insomnia. Insomnia is also a risk factor for the development of mental health disorders, cardiovascular disease and type 2 diabetes. Treating sleep difficulties is critical and researchers from the University of Oxford and Northwestern Medicine have found a way to reach more patients and improve insomnia symptoms via digital programs.
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Insomnia is traditionally treated with medication, but new guidelines published in 2016 by the American College of Physicians recommend Cognitive Behavioural Therapy (CBT) before prescribing sleeping pills. A major limitation of CBT is its lack of providers who deliver the therapy and, as a result, not many patients get the treatment. But this study used an online program to deliver CBT using the Sleepio program and an associated iOS app, which made it accessible to users. The digital program is also automated and tailored to suit the sleep patterns of the patient.
The study involved 1711 participants with self-reported symptoms of insomnia. Digital CBT (dCBT) was delivered to the patients in six sessions lasting an average of 20 minutes. Participants had access to the intervention for 12 weeks. Researchers assessed the participants online at 0 weeks (baseline), four weeks (mid-treatment), eight weeks (post-treatment) and 24 weeks (follow-up). The program content was based on CBT manuals and included behavioural, cognitive and educational components.
In the dCBT group, 689 participants logged on for at least one session, 491 participants completed at least four sessions and 413 participants completed all six sessions. The researchers found that dCBT significantly improved insomnia symptoms, functional health, psychological wellbeing and sleep-related quality of life at four, eight and 24 weeks after initiation of treatment. The improvements in week eight and at 24 weeks were mediated by improvements at week four and eight respectively.
Typically a patient with insomnia will seek treatment when lack of sleep affects their quality of life and daytime functioning. The study shows that dCBT can make a difference in both of these aspects. The results confirm that dCBT improves both daytime and nighttime aspects of insomnia. The results also strengthen the case for dCBT as an effective and inexpensive treatment method, which can help insomnia sufferers achieve a better quality of life.
Source: JAMA Psychiatry
