Cognitive mechanisms of sleep outcomes in a randomized clinical trial of internet-based cognitive behavioral therapy for insomnia

May 21, 2018Sleep medicine

Mental processes linked to sleep improvements in an online therapy trial for insomnia

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Participants receiving SHUTi reported higher levels of insomnia knowledge and lower dysfunctional beliefs about sleep 12 months after the intervention.

Those in the SHUTi group showed increased insomnia knowledge and internal sleep locus of control compared to the education group.
Dysfunctional beliefs and attitudes about sleep decreased significantly in the SHUTi group.
Changes in insomnia knowledge, chance sleep locus of control, and dysfunctional beliefs mediated the relationship between the treatment condition and sleep outcomes at 12 months.
Within the SHUTi group, improvements in cognitive variables were associated with better sleep outcomes one year later.

AI simplified

OBJECTIVE: The aim of this study was to investigate in a randomized clinical trial the role of sleep-related cognitive variables in the long-term efficacy of an online, fully automated cognitive behavioral therapy intervention for insomnia (CBT-I) (Sleep Healthy Using the Internet [SHUTi]).

METHOD: Three hundred and three participants (M = 43.3 years; SD = 11.6) were randomly assigned to SHUTi or an online patient education condition and assessed at baseline, postintervention (nine weeks after baseline), and six and 12 months after the intervention period. Cognitive variables were self-reported internal and chance sleep locus of control, dysfunctional beliefs and attitudes about sleep (DBAS), sleep specific self-efficacy, and insomnia knowledge. Primary outcomes were self-reported online ratings of insomnia severity (Insomnia Severity Index), and sleep onset latency and wake after sleep onset from online sleep diaries, collected 12 months after the intervention period. age

RESULTS: Those who received SHUTi had, at postassessment, higher levels of insomnia knowledge (95% confidence interval [CI] = 0.10-0.16) and internal sleep locus of control (95% CI = 0.04-0.55) as well as lower DBAS (95% CI = 1.52-2.39) and sleep locus of control attributed to chance (95% CI = 0.15-0.71). Insomnia knowledge, chance sleep locus of control, and DBAS mediated the relationship between condition and at least one 12-month postassessment 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 one sleep outcome one year later.

CONCLUSION: Online 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.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Cognitive mechanisms of sleep outcomes in a randomized clinical trial of internet-based cognitive behavioral therapy for insomnia

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief