![]() ![]() Objective To evaluate a web-based, automated CBT-I intervention to improve insomnia in the short term (9 weeks) and long term (1 year).ĭesign, Setting, and Participants A randomized clinical trial comparing the internet CBT-I with internet patient education at baseline, 9 weeks, 6 months, and 1 year. Internet-delivered CBT-I has shown promise as a method to overcome this obstacle however, the long-term effectiveness has not been proven in a representative sample with chronic insomnia. ![]() Importance Although cognitive behavior therapy for insomnia (CBT-I) has been established as the first-line recommendation for the millions of adults with chronic insomnia, there is a paucity of trained clinicians to deliver this much needed treatment. ![]() 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.In the UK, she added, possibilities include increasing access through IAPT (improving access to psychological therapies) services, health visitors or even specialist apps and websites such as Sleepio, which is currently available free through in the NHS in some parts of south-east England. The team said it seemed four to eight sessions of CBT were required for such improvements, with an additional trial finding little benefit when only two CBT sessions were offered to insomniacs.ĭavidson said the new study supported the idea that CBT for insomnia could and should be offered through GPs – patients’ usual first port of call – although, as with most of the studies, the therapy itself could be delivered by others such as nurses, social workers or other primary care services. By contrast, those who were just on a waiting list, or given treatment as usual, only experienced up to four minutes’ improvement in the time it took to drop off and a maximum of eight minutes’ improvement in time spent awake after going to sleep. Looking at results from four randomised control trials, with between 66 and 201 participants of mixed ages, the team found that participants fell asleep on average nine to 30 minutes sooner after completing a course of CBT for insomnia and experienced a reduction of between 22 and 36 minutes in the amount of time spent awake after going to sleep. The results showed CBT for insomnia was effective and led to improvements in sleep that lasted during a follow-up many months later. Why can’t I sleep? My mission to understand insomnia – video In some studies, participants were also taking medication to help them sleep. Writing in the British Journal of General Practice, Davidson and colleagues report how they examined the results from 13 previously conducted studies on the provision of CBT for insomnia through primary care. These include staying away from the bed when awake, challenging attitudes about sleep loss and restricting the number of hours spent in bed. Instead, the main treatment for chronic insomnia is CBT – a programme of changes to the way an individual approaches and thinks about sleep. Sleeping pills are not recommended for long-term use and can have side-effects, as well as posing a risk of addiction. The condition is linked to health problems including depression, as well as difficulties in functioning and sometimes resulting in accidents. Chronic insomnia, in which individuals have difficulties dropping off or staying asleep at least three nights a week for three months or more, is thought to affect about 10-15% of adults. ![]()
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