Dysfunksjonelle oppfatninger og holdninger om søvn medierer utfall ved dCBT-I på psykiske plager, tretthet og alvorlighetsgrad av insomni.

Forskere fra NTNU, St. Olavs hospital, Folkehelseinstituttet, University of Virgina, University of California og University of Newcastle har i denne studien undersøkt om digital kognitiv atferdsterapi for insomni (dCBT-I) forbedrer søvn og helseutfall hos personer med insomni, og om endringer i dysfunksjonell tro og holdninger om søvn ved behandling med dCBT-I medierer endringer i psykiske plager, tretthet og alvorlighetsgrad av insomni. 566 pasienter fikk dCBT-I og 507 pasienter fikk opplæring i søvnhygiene i studien. Funn i studien viser at dysfunksjonelle oppfatninger om søvn medierer endringer i symptomer på psykiske plager, tretthet og alvorlighetsgrad av insomni etter behandling med dCBT-I, sammenlignet med søvnhygieneråd.

Patrick Faaland, Øystein Vedaa, Knut Langsrud, Børge Sivertsen, Stian Lydersen, Simen Berg Saksvik, Cecilie L Vestergaard, Kaia Kjørstad, Daniel Vethe, Lee M Ritterband, Allison G Harvey, Tore C Stiles, Jan Scott, Håvard Kallestad 

Artikkelen er publisert i Sleep Medicine

Objective/background: Digital cognitive behavioral therapy for insomnia (dCBT-I) improves several sleep and health outcomes in individuals with insomnia. This study investigates whether changes in Dysfunctional Beliefs and Attitudes about Sleep (DBAS) during dCBT-I mediate changes in psychological distress, fatigue, and insomnia severity.
Patients/methods: The study presents a secondary planned analysis of data from 1073 participants in a randomized control trial (Total sample = 1721) of dCBT-I compared with patient education (PE). Self-ratings with the Dysfunctional Beliefs and Attitudes about Sleep (DBAS), the Hospital Anxiety Depression Scale (HADS), the Chalder Fatigue Scale (CFQ), and the Insomnia Severity Index (ISI) were obtained at baseline and 9-week follow-up. Hayes PROCESS mediation analyses were conducted to test for mediation.
Results and conclusion: sDBAS scores were significantly reduced at 9-week follow-up for those randomized to dCBT-I (n = 566) compared with PE (n = 507). The estimated mean difference was -1.49 (95% CI -1.66 to -1.31, p < .001, Cohen's d. = 0.93). DBAS mediated all the effect of dCBT-I on the HADS and the CFQ, and 64% of the change on the ISI (Estimated indirect effect -3.14, 95% CI -3.60 to -2.68) at 9-week follow-up compared with PE. Changes in the DBAS fully mediated the effects of dCBT-I on psychological distress and fatigue, and the DBAS partially mediated the effects on insomnia severity. These findings may have implications for understanding how dCBT-I works and highlights the role of changing cognitions in dCBT-I.