Results Of the 1711 participants included in the intention-to-treat analysis, 1329 (77.7%) were female, mean (SD) age was 48.0 (13.8) years, and 1558 (91.1%) were white. Insomnia was assessed with the Sleep Condition Indicator (range: 0-32 higher scores indicate better sleep). Secondary outcomes comprised mood, fatigue, sleepiness, cognitive failures, work productivity, and relationship satisfaction. Main Outcomes and Measures Primary outcomes were scores on self-reported measures of functional health (Patient-Reported Outcomes Measurement Information System: Global Health Scale range, 10-50 higher scores indicate better health) psychological well-being (Warwick-Edinburgh Mental Well-being Scale range, 14-70 higher scores indicate greater well-being) and sleep-related quality of life (Glasgow Sleep Impact Index range, 1-100 higher scores indicate greater impairment). Programs were completed within 12 weeks after inclusion. Online assessments took place at 0 (baseline), 4 (midtreatment), 8 (posttreatment), and 24 (follow-up) weeks. Participants were recruited between December 1, 2015, and December 1, 2016, and dCBT was delivered using web and/or mobile channels plus treatment as usual SHE comprised a website and a downloadable booklet plus treatment as usual. Objectives To investigate the effect of dCBT for insomnia on functional health, psychological well-being, and sleep-related quality of life and to determine whether a reduction in insomnia symptoms was a mediating factor.ĭesign, Setting, and Participants This online, 2-arm, parallel-group randomized trial comparing dCBT for insomnia with sleep hygiene education (SHE) evaluated 1711 participants with self-reported symptoms of insomnia. Most people with insomnia, however, seek help because of the daytime consequences of poor sleep, which adversely affects quality of life. Importance Digital cognitive behavioral therapy (dCBT) is a scalable and effective intervention for treating insomnia. 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.Several authors disclosed financial ties to the pharmaceutical and medical technology industries. "Although sleep hygiene practices are often suggested and well understood by patients, sleep hygiene do not constitute an effective stand-alone therapy," Edinger said in a statement. Sleep hygiene is not recommended for use as a single-component therapy for treatment of chronic insomnia disorder. Conditional recommendations include use of stimulus control, sleep restriction therapy, and relaxation therapy as single-component therapies for treatment of chronic insomnia disorder in adults. The authors strongly recommend that clinicians use multicomponent cognitive behavioral therapy for treatment of chronic insomnia disorder in adults. Edinger, Ph.D., from National Jewish Health in Denver, and colleagues conducted a systematic literature review to evaluate the relevant literature and quality of evidence to develop recommendations for behavioral and psychological treatments for chronic insomnia disorder in adults.
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