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(Reuters Health) – Insomnia sufferers who receive a digitized version of Cognitive Behavior Therapy (CBT) as part of their treatment may find more symptom relief than those who receive only tips to improve their sleep habits, according to recent experience.
The researchers randomly assigned 1,700 patients with insomnia to receive either a digital CBT or a so-called sleep hygiene education, designed to improve bedtime routines and encourage them to avoid substances like caffeine and alcohol that can disrupt sleep.
The CBT group used the Sleepio online program (https://bit.ly/1CIZS9u) and an associated iOS application, which offered a series of 20-minute therapy sessions that users could access for 12 weeks.
Patients reported a greater improvement in their insomnia symptoms after 4, 8 and 24 weeks with a digital CBT compared to a sleep hygiene education, reported the team. study in JAMA Psychiatry.
"This new study indicates that digital TBI can help people with insomnia to not only get a better sleep, but also a better overall health and a better quality of life," said Colin Espie, lead author of the Study, co-founder of Big Health, developer of Sleepio.
"It also underscores earlier findings that better sleep contributes to better mental health," Espie said via e-mail.
CBT can lead people to use techniques that address the mental (or cognitive) factors associated with insomnia, such as "the spirit that wraps up", and overcome the problem. worry and other negative emotions that often accompany the inability to sleep. CBT can also help people with sleep difficulties to put in place a healthy sleep routine and improve sleep habits, have shown previous research.
"Although a fully automated digital solution such as Sleepio can not fully replicate the power of a secure face-to-face relationship between a patient and a clinician, the digital format has several advantages," said Espie.
One of the key benefits is that the app can be available in the middle of the night when people need help, without requiring patients to wait for a therapist to make an appointment, said Espie. Faced with a shortage of providers trained to offer CBT for insomnia, the application could also help to expand access to care for patients who might otherwise not be able to receive treatment .
The patients in this study were on average 48 years old and most were women and white men.
About half of them consumed caffeine at least twice a day and, on average, this group of patients was slightly overweight, two factors that can hinder a good night's sleep.
To evaluate the effectiveness of digital CBT, the researchers asked patients to assess the extent of improvements made to their own physical health, psychological well-being, insomnia and quality of life related to sleep. The study found that on all these measures, the digital TCC seemed to have a greater impact than the sleep hygiene education.
Although the study is a controlled experiment, it was not designed to assess whether, or how, digital CBT could perform better than CBT in person. It is also possible that the results may be different in more diverse patient populations.
Still, the findings offer further evidence of the potential of mobile and web-based therapy as an effective option for treating insomnia, said Ricardo F. Munoz, director of the International Institute of Internet Interventions. for Health (i4Health) and Professor Emeritus. at the University of California at San Francisco
"Dealing with insomnia with CBT has longer-lasting effects than, for example, treating insomnia with medication," said Munoz, not involved in the study, by email. "Because CBT involves learning to sleep well, what the person learns can be used indefinitely, the drugs only work while you use them and can have harmful side effects."
SOURCE: https://bit.ly/2J2BCdd JAMA Psychiatry, online September 25, 2018.
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