Smartphone-based cognitive behavioral therapy found to significantly decrease insomnia, substantially outperforming sleep education

Dig­i­tal Ther­a­py for Insom­nia More Effec­tive Than Sleep Edu­ca­tion, Study Finds (Amer­i­can Jour­nal of Man­aged Care):

A smart­phone-based, Chi­nese culture­–adapted dig­i­tal cog­ni­tive behav­ioral ther­a­py for insom­nia (DCBT‑I) appli­ca­tion improved insom­nia sever­i­ty com­pared with sleep edu­ca­tion, accord­ing to find­ings of a study pub­lished in JAMA Net­work Open.

Researchers want­ed to study the effi­ca­cy of this DCBT‑I app com­pared with sleep edu­ca­tion using the same app … “To our knowl­edge, this is the first RCT [ran­dom­ized clin­i­cal tri­al] in which the con­trol group received sleep edu­ca­tion pro­vid­ed using the same inter­face as an inter­ven­tion,” said the researchers.

This study was a sin­gle-blind­ed RCT con­duct­ed from March 2021 to Jan­u­ary 2022, with screen­ing and ran­dom­iza­tion con­duct­ed at Peking Uni­ver­si­ty First Hos­pi­tal in Chi­na. Fol­low­ing eli­gi­bil­i­ty assess­ment, eli­gi­ble par­tic­i­pants were enrolled and allo­cat­ed 1:1 to DCBT‑I or sleep edu­ca­tion groups, and data were eval­u­at­ed from Jan­u­ary to Feb­ru­ary 2022. A total of 82 par­tic­i­pants were includ­ed in the study, with 41 ran­dom­ized to sleep edu­ca­tion and 41 ran­dom­ized to DCBT‑I.

The DCBT‑I group sig­nif­i­cant­ly out­per­formed the con­trol group in improved insom­nia sever­i­ty and sub­jec­tive sleep qual­i­ty, demon­strat­ing the intervention’s effec­tive­ness. An explorato­ry analy­sis sug­gest­ed that DCBT‑I might be also bet­ter than sleep edu­ca­tion in terms of reduc­ing depres­sion and anx­i­ety, improv­ing qual­i­ty of life, and some of objec­tive sleep qual­i­ty mea­sures, but more study is needed.

The Study:

Dig­i­tal Cog­ni­tive Behav­ioral Ther­a­py for Insom­nia Using a Smart­phone Appli­ca­tion in Chi­na (JAMA Net­work Open). Key Points:

• Ques­tion: Can a dig­i­tal cog­ni­tive behav­ioral ther­a­py for insom­nia (DCBT‑I) appli­ca­tion reduce insom­nia sever­i­ty in the Chi­nese cul­tur­al context?
• Find­ings: In this was sin­gle-blind ran­dom­ized clin­i­cal tri­al includ­ing 82 par­tic­i­pants, use of a smart­phone-based and Chi­nese cul­ture-adapt­ed DCBT‑I app sig­nif­i­cant­ly decreased Insom­nia Sever­i­ty Index scores com­pared with sleep edu­ca­tion using the same app.
• Mean­ing: These find­ings sug­gest that the Chi­nese ver­sion of DCBT‑I had good effi­ca­cy in reduc­ing insom­nia sever­i­ty in the Chi­nese cul­tur­al context.

The Study in Context:

• CVS Health: Cog­ni­tive behav­ioral ther­a­py (CBT) apps may help you more than sleep­ing pills
• NICE in the UK issues rec­om­men­da­tion for Sleepio app
• First Dig­i­tal Health For­mu­la­ry by Express Scripts includes CBT-based pro­grams to treat depres­sion, anx­i­ety and insomnia
• A call to action: We need the right incen­tives to guide eth­i­cal inno­va­tion in neu­rotech and healthcare