Online CBTI helps with insomnia, new study finds

A recent study has found that online CBTI (cognitive behavioral therapy) for insomnia is as effective as face-to-face therapy.

Results of a randomized controlled trial show that both delivery methods were equally effective at improving sleep outcomes measured by sleep diaries.

They were also equally effective at reducing self-reported sleep latency and wake-after-sleep onset.

They also increased total sleep time and sleep efficiency.

Moreover, there were no differences between the two delivery methods in patients’ perception of therapeutic warmth or confidence in the therapist’s skills.

Patients rate online CBTI highly

“The most surprising findings in the study were that, contrary to our hypotheses, participants who received CBT for insomnia via telemedicine rated therapist alliance similarly to participants who received face-to-face CBT for insomnia,” said principal investigator J. Todd Arnedt of the University of Michigan.

“In addition, ratings of satisfaction with treatment were equivalent between face-to-face and telemedicine participants.

Relative to other remote modalities, telemedicine may offer a unique blend of convenience for the patient while preserving the fidelity of the face-to-face interaction.”

Insomnia involves difficulty falling asleep or staying asleep, or regularly waking up earlier than desired, despite allowing enough time in bed for sleep.

Daytime symptoms associated with insomnia include fatigue or sleepiness; feeling dissatisfied with sleep; having trouble concentrating; feeling depressed, anxious, or irritable; and having low motivation or energy.

The most effective treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBTI, sometimes also known as CBT-I).

It combines behavioral strategies, such as setting a consistent sleep schedule and getting out of bed when struggling with sleep, with cognitive strategies, such as replacing fears about sleeplessness with more helpful expectations.

Experts customize CBTI recommendations to address each patient’s individual needs and symptoms.

CBTI and chronic insomnia

The analysis comparing sleep and daytime functioning variables included 47 adults with chronic insomnia, including 33 women.

The analysis of therapeutic alliance involved 38 adults with insomnia, including 25 women.

Participants had an average age of about 52.

The researchers randomized them into six sessions of CBT-I delivered face-to-face, or via the AASM SleepTM telemedicine system.

One therapist delivered CBT-I in both conditions.

“Preliminary findings from this study suggest that patients undergoing telemedicine for insomnia can feel just as close and supported by their therapist as if they were in the office,” said co-author Deirdre Conroy of the University of Michigan.

“Telemedicine could be utilized more for CBT-I to bridge the gap between supply and demand for this service.”

Study: “Comparison of Therapeutic Alliance for Telemedicine vs.

Face-to-Face Delivered Cognitive Behavioral Therapy for Insomnia: Preliminary Results”
Authors: Deirdre A Conroy, Ann Mooney, Dari Pace, Sydney Balstad, Kelley Dubuc, Alexander Yang, and J Todd Arnedt
Published in: Sleep
Publication date: April 12, 2019
DOI: https://doi.org/10.1093/sleep/zsz067.363
Picture: by Adrià Crehuet Cano on Unsplash