Treatment adherence was 78% based on those who completed computerised cognitive-behavioural therapy. Numbers needed to treat across four trials for the outcome of Insomnia Severity Index ranged from 1.44 to 5.36 (average of 3.59). No statistically significant differences were found between groups for wake time after sleep onset (-0.18, 95% CI -0.43 to 0.06 Ι²=55% four trials), total sleep time (0.22, 95% CI -0.03 to 0.46 Ι²=0% four trials) and time in bed (-0.25, 95% CI -0.57 to 0.07 Ι²=0% three trials). Four trials scored 100% on the CASP tool and the other two RCTs did not report on the procedure for randomisation, power analysis or intention-to-treat analysis.Ĭomputerised cognitive-behavioural therapy was statistically superior to control post-treatment for sleep onset latency (-0.55, 95% CI -0.80 to -0.30 Ι²=0% four trials), number of awakenings (-0.45, 95% CI -0.70 to -0.20 Ι²=51% four trials), sleep efficiency (0.40, 95% CI 0.15 to 0.64 Ι²=63% four trials), sleep quality (0.41, 95% CI 0.16 to 0.65 Ι²=45% four trials) and Insomnia Severity Index (-0.86, 95% CI -1.18 to -0.53 Ι²=0% two trials). Six RCTs were deemed to be of good methodological quality and were included in the review (433 participants). Two trials were rejected due to poor methodology. The authors did not state how many people were involved in study selection. CBTI is a scientifically proven, highly effective way to end insomnia without relying on medications such as sleeping pills. The percentage of male patients ranged from 14% to 65%. Cognitive behavioral therapy for insomnia (CBTI) is a 4- to a 6-session treatment program that can help people who have difficulty falling asleep, staying asleep, or find that sleep is unrefreshing. The mean age of patients ranged from 39.6 to 56.7 years (where reported). Study duration, nature and content of the interventions varied across the trials. Most trials used completely self-help computerised programmes minimal therapist support via email was also used. One study used handheld computer devices compared with self help therapy as control. Five trials used internet-based computerised cognitive-behavioural therapy compared with waiting list control. Patients in five out of six trials had a formal diagnosis of insomnia. The Insomnia Severity Index was also used as an outcome measure. Primary outcome variables included sleep onset latency, wake time after sleep onset, total sleep time, number of awakenings, time in bed, sleep efficiency and sleep quality. Alternative treatments and waiting list controls were eligible comparators. Studies had to investigate computerised cognitive-behavioural therapy delivered through a computer and including the specific components sleep hygiene, stimulus control, relaxation training, sleep restriction and cognitive restructuring. Studies of shift workers, those with an acute psychotic or manic disorder, participants with a head injury and those unable to read were excluded. Also look out for the accompanying app, Insomnia Coach, which is well worth checking out for further sleep advice and strategies.Eligible studies needed to include adults (aged 18 and older) with a clinical diagnosis of insomnia according to DSM-IV or ICD-10, insomnia associated with anxiety or depression or insomnia without a clinical diagnosis. Several studies on dCBT-I, with or without human support, have been published, and reviews and meta-analyses have shown that this intervention is effective. However, do take care to download the correct edition, as the US Department of Veterans Affairs has a second app, CBT-i Explorer, which requires a code from a healthcare provider. A 2015 review of over 20 different CBT-I trials found that on average across the studies, insomniacs who used CBT-I fell asleep faster by 20 minutes and spent. With so much content offered for free, it’s difficult to justify paying for any other app. Learn what's causing your sleep problems. The Learn tab contains an extensive catalog of articles written by sleep experts and just about all the information you could ever need. Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills - Mayo Clinic If you find it hard to fall asleep or stay asleep, or you have other long-term sleep problems, behavior therapy can help. It also contains reminder tools for all the factors that might help to improve your bedtime rituals, such as when to stop caffeine, wind down, and go to bed. Although principally designed for use alongside help from a healthcare professional, you can use it without assistance.ĬBT-i Coach provides a comprehensive guide to developing positive sleep routines and gives you a helpful sleep tracker. Designed for veterans and military service members, the US Department for Veterans Affairs provides this CBT-i app for free to help anyone who has insomnia.
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