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Article: Can adding personalized rule-based feedback improve the therapeutic effect of self-help digital cognitive behavioral therapy for insomnia in young adults?
| Title | Can adding personalized rule-based feedback improve the therapeutic effect of self-help digital cognitive behavioral therapy for insomnia in young adults? |
|---|---|
| Authors | |
| Issue Date | 1-Jul-2023 |
| Publisher | Elsevier |
| Citation | Sleep Medicine, 2023, v. 107, p. 36-45 How to Cite? |
| Abstract | IntroductionCognitive-behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia, but low accessibility and relatively high cost limits the dissemination of the treatment. Several forms of digital CBT-I have been developed to increase the accessibility and shown to be effective; however, the treatment effect may be restricted by the lack of interaction within the treatment. The current study examines whether the therapeutic effects of self-help digital CBT-I could be enhanced by adding simple rule-based personalized feedback. MethodNinety-two young adults with self-reported insomnia were randomly assigned to three groups: a self-help group (SH, n = 31), who received an eight-session email-delivered CBT-I program; a feedback group (FB, n = 31), who went through the same CBT-I program with personalized feedback; and a waitlist group (WL, n = 30). The Insomnia Severity Index (ISI) was used as the primary outcome measure, and the 16-item version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), Sleep Hygiene Practice Scale (SHPS), and sleep diary were used as the secondary outcome measures. Treatment satisfaction and adherence were also compared between the treatment groups. ResultsBoth the SH and FB groups showed significantly more improvements in insomnia severity, sleep-related beliefs, and sleep hygiene behaviors than the WL group. Sleep onset latency and sleep efficiency in the sleep diary were also significantly improved after treatment. None of these effects significantly differed between the two treatment groups. Nonetheless, participants in the FB group reported higher treatment satisfaction than those in the SH group. ConclusionThis study supports the effectiveness of email-delivered self-help CBT-I for young adults with insomnia. Furthermore, while adding simple personalized feedback may not have an additional effect on sleep per se, it can enhance treatment satisfaction. This simple intervention shows promise in addressing sleep disturbance in young adults. |
| Persistent Identifier | http://hdl.handle.net/10722/331985 |
| ISSN | 2023 Impact Factor: 3.8 2023 SCImago Journal Rankings: 1.368 |
| ISI Accession Number ID |
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | Yang, Chien-Ming | - |
| dc.contributor.author | Lu, Ya-Li | - |
| dc.contributor.author | Lee, Hsin-Chien | - |
| dc.contributor.author | Li, Shirley | - |
| dc.contributor.author | Suh, Sooyeon | - |
| dc.contributor.author | Okajima, Isa | - |
| dc.contributor.author | Huang, Ya-Chuan | - |
| dc.date.accessioned | 2023-09-28T05:00:03Z | - |
| dc.date.available | 2023-09-28T05:00:03Z | - |
| dc.date.issued | 2023-07-01 | - |
| dc.identifier.citation | Sleep Medicine, 2023, v. 107, p. 36-45 | - |
| dc.identifier.issn | 1389-9457 | - |
| dc.identifier.uri | http://hdl.handle.net/10722/331985 | - |
| dc.description.abstract | <h3>Introduction</h3><p>Cognitive-behavioral therapy for insomnia (CBT-I) is recommended as the first-line <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/therapeutic-procedure" title="Learn more about treatment from ScienceDirect's AI-generated Topic Pages">treatment</a> for insomnia, but low accessibility and relatively high cost limits the dissemination of the treatment. Several forms of digital CBT-I have been developed to increase the accessibility and shown to be effective; however, the treatment effect may be restricted by the lack of interaction within the treatment. The current study examines whether the therapeutic effects of self-help digital CBT-I could be enhanced by adding simple rule-based personalized feedback.</p><h3>Method</h3><p>Ninety-two young adults with self-reported insomnia were randomly assigned to three groups: a self-help group (SH, n = 31), who received an eight-session email-delivered CBT-I program; a feedback group (FB, n = 31), who went through the same CBT-I program with personalized feedback; and a waitlist group (WL, n = 30). The <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia-severity-index" title="Learn more about Insomnia Severity Index from ScienceDirect's AI-generated Topic Pages">Insomnia Severity Index</a> (ISI) was used as the primary outcome measure, and the 16-item version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/sleep-hygiene" title="Learn more about Sleep Hygiene from ScienceDirect's AI-generated Topic Pages">Sleep Hygiene</a> Practice Scale (SHPS), and sleep diary were used as the secondary outcome measures. Treatment satisfaction and adherence were also compared between the treatment groups.</p><h3>Results</h3><p>Both the SH and FB groups showed significantly more improvements in insomnia severity, sleep-related beliefs, and sleep hygiene <a href="https://www.sciencedirect.com/topics/neuroscience/behavior-neuroscience" title="Learn more about behaviors from ScienceDirect's AI-generated Topic Pages">behaviors</a> than the WL group. <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/sleep-onset-latency" title="Learn more about Sleep onset latency from ScienceDirect's AI-generated Topic Pages">Sleep onset latency</a> and sleep efficiency in the sleep diary were also significantly improved after treatment. None of these effects significantly differed between the two treatment groups. Nonetheless, participants in the FB group reported higher treatment satisfaction than those in the SH group.</p><h3>Conclusion</h3><p>This study supports the effectiveness of email-delivered self-help CBT-I for young adults with insomnia. Furthermore, while adding simple personalized feedback may not have an additional effect on sleep per se, it can enhance treatment satisfaction. This simple intervention shows promise in addressing sleep disturbance in young adults.</p> | - |
| dc.language | eng | - |
| dc.publisher | Elsevier | - |
| dc.relation.ispartof | Sleep Medicine | - |
| dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
| dc.title | Can adding personalized rule-based feedback improve the therapeutic effect of self-help digital cognitive behavioral therapy for insomnia in young adults? | - |
| dc.type | Article | - |
| dc.identifier.doi | 10.1016/j.sleep.2023.04.012 | - |
| dc.identifier.scopus | eid_2-s2.0-85153323209 | - |
| dc.identifier.volume | 107 | - |
| dc.identifier.spage | 36 | - |
| dc.identifier.epage | 45 | - |
| dc.identifier.isi | WOS:000989258300001 | - |
| dc.identifier.issnl | 1389-9457 | - |