Long-Term Effects of an Unguided Online Cognitive Behavioral Therapy for Chronic Insomnia
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STUDY OBJECTIVES: The aim of this study was to test the efficacy of fully automated Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) 18 months after the intervention period on sleep, daytime functioning, and beliefs about sleep for adults with chronic insomnia. METHODS: Participants in this study had participated in a randomized controlled trial comparing the efficacy of unguided Internet CBT-I with web-based patient education. Participants who had received Internet CBT-I (n = 95) completed online questionnaires and online sleep diaries 18 months after the intervention period. We used linear mixed models to study changes from baseline to postassessment and to 18-month follow-up, and a separate mixed-models analysis to study changes from postassessment to 18-month follow-up. RESULTS: Mean age of the participants was 45.5 years (standard deviation = 12.6) and 64% were females. Sixty-six participants (70%) completed the 18-month follow-up assessment. There were significant improvements from baseline to 18-month follow-up on the Insomnia Severity Index (ISI) (Cohen d = 2.04 [95% confidence interval (CI) 1.66–2.42]) and the Bergen Insomnia Scale (BIS) (d = 1.64 [95% CI 1.30–1.98]), levels of daytime fatigue (d = 0.85 [95% CI 0.59–1.11]), psychological distress (d = 0.51 [95% CI 0.29–0.73]), and beliefs about sleep (d = 1.44 [95% CI 1.15–1.73]). Moderate to large effect size improvements were also shown on the diary-derived sleep variables. All improvements from baseline to postassessment were essentially maintained to 18-month follow-up. CONCLUSIONS: Unguided Internet CBT-I appears to have sustained effects on sleep, daytime functioning, and beliefs about sleep up to 18 months after the intervention period.
CitationVedaa Ø, Hagatun S, Kallestad H, Pallesen S, Smith ORF, Thorndike FP, Ritterband LM, Sivertsen BS. Long-Term Effects of an Unguided Online Cognitive Behavioral Therapy for Chronic Insomnia. Journal of Clinical Sleep Medicine (JCSM). 2019;15(1):101-110
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