Digitally-delivered cognitive-behavioural therapy for youth insomnia: A systematic review

Abstract

Sleep disturbance is common among young people, with consequences for academic, emotional and behavioural development. Cognitive-behavioural therapy for insomnia (CBT-I) is efficacious, yet it is costly and not available to many who need it. Digitally-delivered CBT-I (eCBT-I) has the potential to overcome these barriers. The purpose of this systematic review was to identify studies which report on the efficacy or effectiveness of eCBT-I for young people with sleep disturbance. Electronic databases were systematically searched and three studies met inclusion criteria. Two studies used the same online intervention for adolescents with insomnia symptoms, while the other was conducted in a college sample of individuals who opted into a stress-management study. Results showed that eCBT-I improved sleep efficiency, sleep quality, sleep-onset latency and total sleep time with effect sizes ranging from 0.17–1.30 (Cohen's d). This suggests that eCBT-I is a promising intervention for young people, but more studies are needed to verify the conditions under which it is most effective.

Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth

“…A second way to enhance scalability of evidence-based treatments is to consider digital, or internet-based, versions rather than those using in-person delivery. Growing research indicates that digital interventions are feasible and acceptable for youth (Friedberg et al, 2014;Richardson, Stallard, & Velleman, 2010) and may be just as efficacious as in-person delivery (Werner-Seidler, Johnston, & Christensen, 2018;Zachariae, Lyby, Ritterband, & O'Toole, 2016). Moreover, young people are likely to choose electronic versions of interventions when available (de Bruin, Bogels, Oort, & Meijer, 2015).…”

Digital Delivery of Cognitive Behavioral Therapy for Insomnia

“…The positive effects of dCBT on insomnia symptoms are not only seen in adults with insomnia solely. These effects were also established in adolescents [ 31 , 64 ], breast cancer survivors [ 65 ], and patients with concurrent disorders such as depression [ 38 , 57 ], tinnitus [ 45 ], asthma [ 54 ], or heightened blood pressure [ 48 ] for example. This suggests that dCBT can be of use in a range of populations, even when the target population has insomnia concurrent with other disorders.…”

Pilot evaluation of the Sleep Ninja: a smartphone application for adolescent insomnia symptoms

“…This study makes a unique contribution to the literature by showing that smartphone delivery of CBT-I is a promising format in which to deliver this gold-standard intervention. This is the first study that we are aware of that has evaluated app-delivered CBT-I in young people,21 and only the second study that has tested mobile phone delivery of CBT-I, the first study being conducted in adults, with positive effects on sleep outcomes 48. Using smartphones to deliver interventions such as this offer a myriad of advantages, including immediate connectivity to automated interactive applications that can be accessed anytime, anywhere.…”

“…Sleep is typically less stigmatised than disorders like depression, suggesting that targetting sleep it may be more appealing to adolescents. Currently, there are no digital CBT-I programmes that are commercially available for youth 21. The overall objective of this study was to evaluate a newly developed digital CBT-I programme for adolescents with sleep difficulties.…”