![]() ![]() 11 Meta-analyses indicate that CBTI has moderate to large lasting effects on insomnia severity, sleep quality, sleep efficiency, sleep-onset latency, and wake-up time after sleep onset. 6, 7 Cognitive behavioral therapy (CBT) for insomnia (CBTI) has been recommended as an effective first choice intervention for chronic insomnia disorder, 8, 9 and it has been found to be effective for improving insomnia symptoms in 70% to 80% of patients 10 and to have a long-term preventive effect on symptom recurrence. 1 - 3 Additionally, 10% to 15% of people with insomnia experience chronic insomnia, 1, 4, 5 which is associated with the development or relapse of depression, as well as resistance to depression treatment. Nearly 20% of the general adult population is reported to have experienced symptoms of insomnia. Trial Registration umin.ac.jp/ctr Identifier: UMIN000036572 In future research, it would be informative to investigate the reasons for dropout during the follow-up period. The tailored BBTI led to improved worker productivity compared with standard BBTI (g = 0.94 P = .01) at the 3-month follow-up.Ĭonclusions and Relevance These findings suggest that an application for individually tailored BBTI is an inexpensive and effective treatment for insomnia. Tailored BBTI was only more effective for improvement of work performance ( g = –1.09 P = .005), social disabilities related to family life (g = –0.89 P = .005), and sleep reactivity ( g = –1.09 P = .007) compared with the waiting list control group at the 3-month follow-up. Tailored BBTI quickly reduced insomnia severity (1-month follow-up: g = –0.85 ). Compared with the waiting list control group, the BBTI interventions were more effective for reduction of insomnia severity (tailored BBTI: Hedges g = –1.64 P < .001 standard BBTI: g = –1.28 P < .001), social disabilities relating to social life (tailored BBTI: g = –1.33 P < .001 standard BBTI: g = –0.84 P = .009), and dysfunctional beliefs (tailored BBTI: g = –1.17 P < .001 standard BBTI: g = –0.84 P = .02) at the 3-month follow-up. The results of the intent-to-treat analysis showed an interaction effect for all outcome measures. At baseline, there were no significant differences among groups on any demographic characteristics or outcome measures. Results A total of 92 participants (mean age, 42.7 years 60 men) were randomized and included in analysis, with 24 participants assigned to tailored BBTI, 23 participants assigned to standard BBTI, 23 participants assigned to self-monitoring, and 22 participants assigned to the waiting list control group. All measures were taken before and after the intervention and at 1-month and 3-month follow-ups. Secondary outcomes were dysfunctional beliefs, sleep reactivity, and work productivity. Main Outcomes and Measures Primary outcomes were insomnia severity, measured using the Japanese version of the Insomnia Severity Index, and social disabilities, measured using the Japanese version of the Sheehan Disability Scale. Interventions A personalized BBTI and standard BBTI intervention, both of which included sleep scheduling, relaxation, sleep hygiene, and sleep diaries, administered via smartphone application. Data were analyzed from February 24, 2018, to February 22, 2019. The study was conducted from September 21, 2017, to February 23, 2018. Participants were recruited via internet advertisements and workplace flyers and randomized to tailored BBTI, standard BBTI, self-monitoring with sleep diaries, or a waiting list control group. Objective To examine the effects of using a fully automated and individually tailored brief behavior therapy for insomnia (BBTI) applications for 2 weeks on insomnia-related symptoms, social disabilities, and work productivity among workers with insomnia in Japan.ĭesign, Setting, and Participants This intent-to-treat prospective parallel-group randomized clinical trial included participants 20 years or older with Insomnia Severity Index (ISI) scores of 8 or higher. However, it has been reported that studies using fully automated cognitive behavioral therapy for insomnia applications without expert support have high dropout rates. Importance According to the stepped-care model, there is a medium to large effect size for using cognitive behavioral therapy for insomnia that is delivered digitally, such as a smartphone application. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |