![]() The current study focused on patients diagnosed with insomnia, or insomnia comorbid with anxiety, or with depression or anxiety disorders, which are the most common insomnia-related mental health complaints in the clinic. In real-world settings, it remains unclear how effective dCBT-I may be in patients with a chief complaint of insomnia or dissatisfaction with sleep quality, assessed by a sleep clinic in a psychiatric hospital. Additionally, clinical studies indicate that dCBT-I is effective in decreasing insomnia severity and improving sleep quality in insomnia and other comorbid mental disorders. In a randomized controlled trial, we found that dCBT-I is as effective as face-to-face individual CBT-I in decreasing sleep onset latency and improving sleep efficiency in patients with insomnia, but dCBT-I is superior in decreasing use of sleep medication and improving daytime function. dCBT-I is non-inferior ineffectiveness compared to face-to-face delivery of CBT, and it is remotely and rapidly accessible. With recent developments in internet technology, an innovative and interactive solution has been developed to deliver digital CBT-I (dCBT-I) via online platforms and digital media. CBT-I is equally effective for treating insomnia in the short term, but its effect is more durable than medications. CBT-I is a directive, sleep-focused and time-limited psychotherapeutic method designed to modify behavioral and thinking patterns that are presumed to exacerbate or perpetuate insomnia. In this context, cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line therapy for all patients with insomnia, including those with coexisting conditions. Given the severe health consequences of insomnia, there is an urgent need for feasible, acceptable and effective interventions to alleviate insomnia symptoms. Persistent insomnia over six years is associated with increased risk for all-cause and cardiopulmonary mortality relative to intermittent insomnia or lack of insomnia. In addition, sleep disturbances influencing global functioning are associated with increased risk for cause-specific work disability, subsequent disabling mental disorders and various physical illnesses. A bidirectional relationship may exist between insomnia, anxiety and depression, whereby insomnia may predict and be predicted by anxiety and depression. Additionally, insomnia is a risk factor for major depressive disorder, anxiety disorders, substance use problems, hypertension, diabetes and other morbidities. Insomnia has several detrimental consequences, including fatigue, low work productivity, and reduced neurocognitive functions. Insomnia, which affects 10 to 15% of the general population, is characterized by dissatisfaction with sleep quality or duration and difficulty initiating or maintaining sleep, and is accompanied by daytime functioning deficits. Trial registrationĬhinese Clinical Trial Registry (ChiCTR1900022699). The current findings suggest dCBT-I is a practical and effective approach for lessening insomnia symptoms, especially for patients with anxiety symptoms suggesting with a more extended intervention period (i.e., 12 weeks). A time-by-treatment interaction was detected in anxiety patients indicating differential reduction in PSQI scores over time between different treatment options. Compared to 8-week follow-up, PSQI scores at 12-week were significantly decreased in the depression group receiving combined therapy and in the anxiety group treated with dCBT-I monotherapy and with combined therapy. ![]() Improvements of sleep quality from baseline to 8-week follow-up were significant in each treatment type. Patients treated with dCBT-I monotherapy were younger, with a more frequent family history of insomnia compared to those with medication monotherapy and those with combined dCBT-I and medication therapy. Data were analyzed with non-parametric tests for repeated measures. At 8- and 12-week follow-up, 509 patients were reassessed. The primary outcome was change in global sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). ![]() A mobile app was developed for self-reported assessment and delivering dCBT-I interventions and treatment prescriptions to participants. Patients were diagnosed with insomnia, anxiety disorders, or anxiety comorbid with insomnia or depression according to ICD-10. ![]() The study included 6,002 patients aged 18 years and above with primary complaints of dissatisfying sleep from a sleep clinic in a psychiatric hospital from November 2016 to April 2021. This study examined the effect of dCBT-I for improving sleep quality in patients with insomnia complaints from a clinical population in a real-world setting. Digital cognitive behavior therapy for insomnia (dCBT-I) is an effective treatment in alleviating insomnia. ![]()
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