Stimulus Control Instructions

Study Objectives: The use of telemedicine with a mobile application (MA) and a wearable device (WD) for the management of sleep disorders has recently received considerable attention. We designed an MA synchronizable with a WD for insomnia treatment. Our pilot study determined the efficacy of simplified group cognitive behavioral therapy for insomnia (CBT-I) delivered using our MA and assessed participant adherence to and satisfaction with the device. Methods: The efficacy of the CBT-I using MA (CBT-I-MA) was assessed by comparing sleep variables (sleep efficiency [SE], Insomnia Severity Index [ISI], and Pittsburgh Sleep Quality Inventory [PSQI] scores) before and after a 4-week treatment protocol in 19 patients with insomnia disorder patients. SE was assessed using a sleep diary, actigraphy, and the PSQI. Results:The intervention significantly improved all three measures of SE (P < .05), and the response rate to treatment was high (94.7%). Total ISI and PSQI scores and sleep latency, as measured by the sleep diary, improved significantly. Participants showed relatively good adherence to our MA, and sleep diary entries were made on 24.3 ± 3.8 of 28 days. Moreover, 94.7% of the participants reported that our MA was effective for treating insomnia. Conclusions: Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA. Keywords: cognitive behavioral therapy, insomnia, mobile application, telemedicine, wearable device Citation: Kang SG, Kang JM, Cho SJ, Ko KP, Lee YJ, Lee HJ, Kim L, Winkelman JW. Cognitive behavioral therapy using a mobile application synchronizable with wearable devices for insomnia treatment: a pilot study.

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“…The core treatments were sleep restriction therapy (SRT) and stimulus control therapy (SCT). 12,13 Our MA used a consensus sleep diary.…”

Section: Development Of the Mamentioning

confidence: 99%

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study

Kang

Cho

et al. 2017

Journal of Clinical Sleep Medicine

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“…It is completed by patients each week to gauge insomnia severity at baseline and monitor treatment progress. As described below, the 4 major therapy components included in the VA CBT-I protocol are stimulus control, 25 sleep restriction, 26 methods to reduce arousal in bed, and sleep-focused cognitive therapy. Clinicians also provide tailored sleep education to support engagement in the above components, as well as education about sleep hygiene (e.g., how substances and medications, exercise and diet, and aging affect sleep).…”

Section: The Va Cbt-i Protocolmentioning

confidence: 99%

CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia

Kuhn

Weiß

Taylor

et al. 2016

Journal of Clinical Sleep Medicine

122

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Study Objectives: This paper describes CBT-I Coach, a patient-facing smartphone app designed to enhance cognitive behavioral therapy for insomnia (CBT-I). It presents findings of two surveys of U.S. Department of Veterans Affairs (VA) CBT-I trained clinicians regarding their perceptions of CBT-I Coach before it was released (n = 138) and use of it two years after it was released (n = 176). Methods: VA-trained CBT-I clinicians completed web-based surveys before and two years after CBT-I Coach was publicly released. Results: Prior to CBT-I Coach release, clinicians reported that it was moderately to very likely that the app could improve care and a majority (87.0%) intended to use it if it were available. Intention to use the app was predicted by smartphone ownership (β = 0.116, p < 0.05) and perceptions of relative advantage to existing CBT-I practices (β = 0.286, p < 0.01), compatibility with their own needs and values (β = 0.307, p < 0.01), and expectations about the complexity of the app (β = 0.245, p < 0.05). Two years after CBT-I Coach became available, 59.9% of participants reported using it with patients and had favorable impressions of its impact on homework adherence and outcomes. Conclusions: Findings suggest that before release, CBT-I Coach was perceived to have potential to enhance CBT-I and address common adherence issues and clinicians would use it. These results are reinforced by findings two years after it was released suggesting robust uptake and favorable perceptions of its value. I NTRO DUCTI O NCognitive behavioral therapy for insomnia (CBT-I) is an evidence-based psychotherapy shown to effectively treat chronic insomnia. Numerous randomized controlled trials, summarized in several meta-analyses, have demonstrated that CBT-I leads to significant decreases in symptoms of insomnia and improvement in sleep efficiency, sleep fragmentation, and sleep onset latency.

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“…Stimulus control approaches, therefore, aims to maximise the stimulus control properties of the bedroom and recondition the environmental cues. 41 Using a model of stimulus control described by Espie,42 patients were advised on: (1) appropriate presleep activities; (2) the management of delayed sleep onset, and (3) the management of episodes of intervening wakefulness (see Appendix 2c).…”

Section: Session 3: Stimulus Control Proceduresmentioning

confidence: 99%

Psychological treatment for insomnia in the regulation of long-term hypnotic drug use

Morgan

Dixon²,

Mathers³

et al. 2004

Health Technol Assess

196

117

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Stimulus Control Instructions

Cited by 208 publications

References 4 publications

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study

CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia

Psychological treatment for insomnia in the regulation of long-term hypnotic drug use

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