Internet-delivered cognitive-behavioral therapy for insomnia and comorbid symptoms

Susanne Hagatun, Øystein Vedaa, Allison G. Harvey, Tine Nordgreend, Otto R.F. Smith, Ståle Pallesen, Odd E. Havik, Frances P. Thorndike, Lee M. Ritterband, Børge Sivertsen

Studien er publisert i Internet Interventions

Abstract:

Background: Cognitive-behavioral therapy for insomnia (CBTi) is considered the standard treatment. The internet has proven to be a useful and successful tool of providing CBTi. However, few studies have investigated the possible effect of unguided internet-delivered CBTi (ICBTi) on comorbid psychological symptoms and fatigue.

Methods: Based on a randomized controlled trial, we investigated whether unguided ICBTi had an effect on comorbid psychological symptoms. Adults with insomnia (n=181; 67% women; mean age 44.9 years [SD13.0]) were randomized to ICBTi (n=95) or to an online patient education condition (n=86) for a nine-week period.

Results: The results from mixed linear modelling yielded medium to large between-group effect sizes from pre- to post-treatment for symptoms of anxiety or depression (d=−0.57; 95% CI=0.79–0.35) and fatigue (d=0.92;95% CI=1.22–0.62). The ICBTi group was reassessed at a 6-month non-randomized follow-up, and the completing participants had on the average a significant increase (from the post-assessment) on symptoms of anxiety or depression, while the reduction in symptoms of fatigue (on post-assessment) was maintained. However, due tohigh dropout attrition and no control group data, caution should be made regarding the long-term effects. In conclusion, the present findings show that unguided ICBTi positively influence comorbid symptoms in the shortterm, thereby emphasizing the clinical relevance of unguided ICBTi. Trial registration: ClinicalTrials.gov identifier: NCT02261272