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Digital Cognitive Therapy Eases Daytime Effects of Insomnia

Benefits include better functional health, sleep-related quality of life, psychological well-being

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FRIDAY, Oct. 5, 2018 (HealthDay News) -- Digital cognitive behavioral therapy (dCBT) is effective in improving functional health, psychological well-being, and sleep-related quality of life in people reporting insomnia, according to a study published online Sept. 25 in JAMA Psychiatry.

Colin A. Espie, Ph.D., from the University of Oxford in the United Kingdom, and colleagues assessed the effect of dCBT for insomnia on functional health, psychological well-being, and sleep-related quality of life among 1,711 participants (77 percent female) with self-reported symptoms of insomnia. Participants were randomized to dCBT for insomnia or sleep hygiene education (SHE). Functional health was measured on a scale of 10 to 50, with higher scores indicating better health; psychological well-being was measured on a scale of 14 to 70, with higher scores indicating greater well-being; and sleep-related quality of life was measured on a scale of 1 to 100, with higher scores indicating greater impairment.

The researchers found that use of dCBT was associated with a small improvement in functional health compared with SHE (adjusted difference at week four: 0.9, 95 percent confidence interval [CI], 0.4 to 1.4; at week eight: 1.76, 95 percent CI, 1.24 to 2.28; at week 24: 1.76, 95 percent CI, 1.22 to 2.3; all P < 0.01). There was also a small improvement in psychological well-being (adjusted difference at week four: 1.04, 95 percent CI, 0.28 to 1.8; at week eight: 2.68, 95 percent CI, 1.89 to 3.47; at week 24: 2.95, 95 percent CI, 2.13 to 3.76; all P < 0.01). There was a large improvement in sleep-related quality of life associated with dCBT (adjusted difference at week four, −8.76; at week eight, −17.6; at week 24, −18.72; all P < 0.01). These outcomes were mediated by a large improvement in insomnia (range mediated, 45.5 to 84 percent).

"These results confirm that dCBT improves both daytime and nighttime aspects of insomnia, strengthening existing recommendations of CBT as the treatment of choice for insomnia," the authors write.

Several authors disclosed financial ties to health and sleep improvement companies, including Big Health Ltd., which funded the study.

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