Adapted digital cognitive behavioural therapy helps the sleepless get better night's sleep

A smartphone-based Chinese culture-adapted digital cognitive behavioural therapy for insomnia (DCBT-I) appears beneficial, producing improvements in the severity of insomnia as compared with sleep education, according to a study.

A single-blinded, randomized clinical trial was conducted, wherein 82 participants (mean age 49.67 years, 74.4 percent women) with chronic insomnia disorder were assigned one of the two intervention groups: DCBT-I (n=41) or sleep education (n=41). A Chinese smartphone-based app with the same interface was used in both intervention groups. The intervention lasted for 6 weeks.

Follow-up visits were conducted at months 1, 3, and 6. Insomnia Severity Index (ISI) scores were assessed as the primary endpoint. Secondary and exploratory endpoints included sleep diary measures, smart bracelet measures, and self-reported scales assessing dysfunctional beliefs about sleep, mental health, and quality of life.

A total of 77 participants completed the 6-week intervention (DCBT-I, n=38; sleep education, n=39), while 73 completed the 6-month follow-up (per protocol data set). The DCBT-I group showed significantly lower mean ISI scores compared with the sleep education group both after the 6-week intervention (12.7 vs 14.9 points; p=0.048) and at the 3-month follow-up (12.1 vs 14.8 points; p=0.04).

Both intervention groups achieved significant improvements from baseline to after the intervention, with large effect sizes (sleep education: Cohen d=1.13; DCBT-I: Cohen d=1.71).

Compared with sleep education, DCBT-I led to greater improvements in some of the sleep diary measures and self-reported scales, such as total sleep time (3 months: 403.9 vs 363.2 minutes; 6 months: 420.3 vs 389.7 minutes) and sleep efficiency (3 months: 87.4 percent vs 76.7 percent; 6 months: 87.5 percent vs 78.1 percent).