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Preliminary results from two badyzes of an ongoing study suggest that cognitive-behavioral therapy for insomnia delivered by telemedicine is as effective as face-to-face delivery.
The results of a randomized controlled trial of non-inferiority show that both delivery methods are equally effective in improving sleep outcomes measured by sleep diaries, reducing sleep latency and waking up after sleep. wake up while increasing total sleep time and sleep efficiency. Nor was there any difference between the two modes of delivery with respect to the patient's perception of the therapeutic alliance, the warmth, and the confidence in the therapist's skills.
The most surprising results of the study are that, contrary to our hypotheses, participants who received CBT for insomnia via an alliance of therapists rated by telemedicine are similar to participants who received a face-to-face CBT for insomnia. In addition, ratings of satisfaction with treatment were equivalent between face-to-face participants and telemedicine participants. Compared to other remote modalities, telemedicine can offer a unique blend of convenience to the patient while preserving the fidelity of face-to-face interaction. "
J. Todd Arnedt, Ph.D., Principal Investigator, Associate Professor of Psychiatry and Neurology and Co-Director of the Michigan Sleep and Circadian Research Laboratory, University of Michigan, Ann Arbor
Insomnia involves difficulty falling asleep or staying asleep, or waking up regularly earlier than desired, even leaving enough time in bed to sleep. Diurnal symptoms badociated with insomnia include fatigue or drowsiness; feel unsatisfied with sleep have trouble concentrating feel depressed, anxious or irritable and having a low motivation or energy.
The most effective treatment for chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). It combines behavioral strategies, such as defining a consistent sleep schedule and getting up off the bed when sleep is difficult, with cognitive strategies, such as replacing the fear of having a good night's sleep. insomnia by more useful expectations. CBT-I recommendations are customized to meet the needs and symptoms of each patient.
The badysis comparing the variables of sleep and daytime functioning included 47 adults with chronic insomnia, including 33 women. The badysis of the therapeutic alliance concerned 38 adults with insomnia, including 25 women. Participants had an average age of about 52 years. They were randomized to six CBT-I sessions delivered face-to-face or via the AASM SleepTM telemedicine system. One therapist delivered CBT-I in both cases.
"Preliminary results from this study suggest that patients undergoing telemedicine for insomnia may feel as close and supportive of their therapist as they were in the office," said co-investigator Deirdre Conroy, Ph.D. badociate professor of clinical psychiatry. and clinical director of the Behavioral Sleep Medicine Program at Michigan Medicine at the University of Michigan at Ann Arbor. "Telemedicine could be used more for CBT-I to bridge the gap between supply and demand for this service."
The two research summaries were recently published in an online supplement of Sleep magazine and will be presented on Monday, June 10 in San Antonio at SLEEP 2019, the 33rd annual meeting of the Associated Professional Sleep Societies LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.
Source:
American Academy of Sleep Medicine
Journal reference:
Arnedt, J.T. et al. (2019) Comparison between the therapeutic alliance for telemedicine and cognitive-behavioral therapy delivered face-to-face for insomnia: preliminary results. To sleep. doi.org/10.1093/sleep/zsz067.363.
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