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Online Cognitive Behavioral Therapy for Insomnia

Sleep Med; ePub 2017 Dec 20; Chow, Ingersoll, et al

Online cognitive behavioral therapy for insomnia (CBT-I) may reduce the enormous public health burden of insomnia by changing underlying cognitive variables that lead to long-term changes in sleep outcomes, a recent study found. 303 participants (mean age=43.3, SD=11.6) were randomly assigned to Sleep Healthy Using the Internet (SHUTi), an online, fully automated cognitive behavioral therapy intervention for insomnia, or an online patient education condition. They were assessed at baseline, post-intervention (9 weeks after baseline), and 6- and 12-months after the intervention period. Researchers found:

  • Those who received SHUTi had, at post-assessment, higher levels of insomnia knowledge and internal sleep locus of control, and lower dysfunctional beliefs and attitudes about sleep and sleep locus of control attributed to chance.
  • Insomnia knowledge, chance sleep locus of control, and dysfunctional beliefs and attitudes about sleep mediated the relationship between condition and at least 1 post-12-month sleep outcome.
  • Within the SHUTi condition, changes in each cognitive variable (with the exception of internal sleep locus of control) predicted improvement in at least 1 sleep outcome 1 year later.

Citation:

Chow PI, Ingersoll K, Thorndike FP, et al. Cognitive mechanisms of sleep outcomes in a randomized clinical trial of Internet-based cognitive behavioral therapy for insomnia. [Published online ahead of print December 20, 2017]. Sleep Med. doi:10.1016/j.sleep.2017.11.1140.

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