Digital Cognitive Behavioral Therapy (dCBT) for Insomnia: a State-of-the-Science Review

Luik, Annemarie I.; Kyle, Simon D.; Espie, Colin A.

doi:10.1007/s40675-017-0065-4

Cited by 121 publications

(92 citation statements)

References 71 publications

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“…Digital therapies are a type of minimal contact therapy, because individuals are able to access the intervention content in their own home and complete it at their own pace. In the last decade, there has been an explosion of available digital CBT‐I (dCBT‐I) programs that have proven effective, with effect sizes comparable to that of face‐to‐face therapy . The unique aspects of dCBT‐I could make it very suitable for individuals with CM .…”

Section: Introductionmentioning

confidence: 99%

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

et al. 2020

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Objective/Background.-Insomnia commonly co-occurs with chronic migraines (CM). Non-pharmacological treatments for insomnia in CM patients remain understudied. This is a proof-of-concept study, which aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital cognitive behavioral therapy for insomnia (dCBT-I) for individuals with CM and insomnia (CM-I) in the United States.Methods.-We recruited 42 females with CM-I symptoms from a U.S.-based observational cohort and from the general population via advertisements. Within a multiple baseline design, participants were randomized to receive dCBT-I after 2, 4, or 6 weeks of completing baseline sleep diaries. DCBT-I was scrutinized against benchmarks for completion rates (≥90% to complete dCBT-I), acceptability (≥80% to find dCBT-I acceptable), and posttreatment changes in insomnia symptoms (≥50% indicating a clinically relevant improvement in their insomnia symptoms). As a secondary measure, we also reported percentage of individuals reverting to episodic migraines. Results.-Out of 42 randomized, 35 (83.3%) completed dCBT-I within the 12 weeks provided. Of these completers, 33 (94.3%) reported being satisfied (n = 16) or very satisfied (n = 17) with treatment. Additionally, 65.7% of completers responded to treatment as per universally accepted criteria for insomnia. Lastly, 34% of completers reverted from CM to episodic migraine. Conclusion.-This study provides evidence for the feasibility and acceptability of dCBT-I in patients with CM-I complaints. Effects of improving insomnia and migraines were suggested. These results indicate that a randomized controlled trial is needed to determine the efficacy of dCBT-I in CM patients.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Introductionmentioning

confidence: 99%

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

et al. 2020

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“…Digital CBT, or CBT delivered primarily via software applications on digital devices (e.g. computers, tablets, and smartphones) [20], provides a solution to help overcome treatment accessibility barriers and has the potential to increase dissemination of CBT. The importance of using digital technologies for improving mental health care is now well recognised [21] and there are a number of advantages offered by digital CBT.…”

Section: Introductionmentioning

confidence: 99%

“…Digital CBT is cost effective [22,23] scalable across people and geographies, and may reduce additional difficulties with attending appointments in person such as time constraints and stigma [18,19]. Additionally, using algorithms, digital CBT has the potential to not only provide standardised and reliable, high-quality interventions for anyone, but can also be tailored to individual needs [20] thereby offering personalised psychological therapy.…”

Section: Introductionmentioning

confidence: 99%

“…standalone functioning without human input) and is delivered entirely via a smartphone application (app). This form of digital CBT takes advantage of the wide uptake of smartphone devices and offers the fewest barriers to accessibility and greatest potential for scalability [20]. A waitlist control group comparison is appropriate to test the efficacy and safety of this new intervention in this population [30].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of digital cognitive behavioural therapy for symptoms of generalised anxiety disorder: a study protocol for a randomised controlled trial

Henry

Espie

et al. 2020

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Background: Generalised anxiety disorder (GAD) is a chronic and disabling condition with considerable personal and economic impact. Cognitive behavioural therapy (CBT) is a recommended psychological therapy for GAD; however, there are substantial barriers to accessing treatment. Digital CBT, in particular smartphone-delivered CBT, has the potential to improve accessibility and increase dissemination of CBT. Despite the emerging evidence of smartphone-based psychological interventions for reducing anxiety, effect size scores are typically smaller than inperson interventions, and there is a lack of research assessing the efficacy of smartphone-delivered digital interventions specifically for GAD. Methods: In the DeLTA trial (DigitaL Therapy for Anxiety), we plan to conduct a parallel-group superiority randomised controlled trial examining the efficacy of a novel smartphone-based digital CBT intervention for GAD compared to a waitlist control. We aim to recruit 242 adults (aged 18 years or above) with moderate-to-severe symptoms of GAD. This trial will be conducted entirely online and will involve assessments at baseline (week 0; immediately preceding randomisation), mid-intervention (week 3), post-intervention (week 6; primary end point) and follow-up (week 10). The primary objective is to evaluate the efficacy of the intervention on GAD symptom severity compared to a waitlist control at post-intervention. Secondary objectives are to examine between-group effects on GAD at follow-up, and to examine the following secondary outcomes at both post-intervention and follow-up: 1) worry; 2) depressive symptoms; 3) wellbeing; 4) quality of life; and 5) sleep difficulty. Discussion: This trial will report findings on the initial efficacy of a novel digital CBT intervention for GAD. Results have the potential to contribute towards the evidence base for digital CBT for GAD and increase the dissemination of CBT.

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“…It is also possible that CBT-I as an adjunct to depression treatment reduces both depression (15) and suicidality. Lowercost, efficacious, and scalable CBT-I options may also be worth examining, including brief behavioral treatment for insomnia (16) and self-guided online CBT-I programs (17). For instance, the Sleep Healthy Using The Internet (SHUTi) program reduces depression symptoms and may similarly reduce suicidality.…”

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confidence: 99%

Reducing Suicidality Through Insomnia Treatment: Critical Next Steps in Suicide Prevention

Hamilton

Buysse

2019

AJP

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Digital Cognitive Behavioral Therapy (dCBT) for Insomnia: a State-of-the-Science Review

Cited by 121 publications

References 71 publications

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

Efficacy of digital cognitive behavioural therapy for symptoms of generalised anxiety disorder: a study protocol for a randomised controlled trial

Reducing Suicidality Through Insomnia Treatment: Critical Next Steps in Suicide Prevention

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