Susanne Hagatun1, Øystein Vedaa1,2, Tine Nordgreen3,4, Otto R F Smith1, Ståle Pallesen2,5, Odd E Havik3, Bjørn Bjorvatn5,6, Frances P Thorndike7, Lee M Ritterband7, Børge Sivertsen1,8,9. 1. a Department of Health Promotion , Norwegian Institute of Public Health , Bergen , Norway. 2. b Department of Psychosocial Science , University of Bergen , Bergen , Norway. 3. c Department of Clinical Psychology , University of Bergen , Bergen , Norway. 4. d Anxiety Disorders Research Network, Haukeland University Hospital , Bergen , Norway. 5. e Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital , Bergen , Norway. 6. f Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway. 7. g Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences , University of Virginia Health System , Charlottesville , Virginia. 8. h The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health , Bergen , Norway. 9. i Department of Research and Innovation , Helse Fonna HF , Haugesund , Norway.
Abstract
OBJECTIVE:Insomnia is a major health problem, and the need for effective and accessible treatment is urgent. The aim of the current study was to evaluate the short-term efficacy of an unguided Internet-based cognitive-behavioral treatment program for insomnia (CBTi), called SHUTi (Sleep Healthy Using the Internet). METHODS: This study used a parallel arm randomized controlled trial in Norway. Participants were randomly allocated to the SHUTi condition or a Web-based patient education condition. Both groups were assessed before and after the nine-week intervention period (online sleep diaries and questionnaires). The SHUTi participants were reassessed in a six-month nonrandomized follow-up. Primary outcome measures were the Insomnia Severity Index (ISI) and the Bergen Insomnia Scale (BIS). RESULTS:A total of 181 participants were included in the study; SHUTi condition (n = 95), patient education condition (n = 86). Intention-to-treat mixed-model repeated-measures analysis revealed that the SHUTi group had better short-term outcomes compared with the patient education group on most sleep measures. The SHUTi group showed a significant decrease on the primary outcomes, the ISI (dbetween = -1.77, 95% CI = -2.23, -1.31) and the BIS (dbetween = -1.00, 95% CI = -1.32, -.68). Improvements were maintained among the completing SHUTi participants at the six-month nonrandomized follow-up. However, dropout attrition was high. CONCLUSION:Unguided Internet-based CBTi produced significant short-term improvements in sleep in patients with chronic insomnia. This highlights the benefits of making Internet-delivered CBTi programs available as a standard first-line treatment option in public health services. Nevertheless, the rate of dropout attrition (participants not completing post-assessment) in this trial limits the generalizability of the findings.
RCT Entities:
OBJECTIVE:Insomnia is a major health problem, and the need for effective and accessible treatment is urgent. The aim of the current study was to evaluate the short-term efficacy of an unguided Internet-based cognitive-behavioral treatment program for insomnia (CBTi), called SHUTi (Sleep Healthy Using the Internet). METHODS: This study used a parallel arm randomized controlled trial in Norway. Participants were randomly allocated to the SHUTi condition or a Web-based patient education condition. Both groups were assessed before and after the nine-week intervention period (online sleep diaries and questionnaires). The SHUTi participants were reassessed in a six-month nonrandomized follow-up. Primary outcome measures were the Insomnia Severity Index (ISI) and the Bergen Insomnia Scale (BIS). RESULTS: A total of 181 participants were included in the study; SHUTi condition (n = 95), patient education condition (n = 86). Intention-to-treat mixed-model repeated-measures analysis revealed that the SHUTi group had better short-term outcomes compared with the patient education group on most sleep measures. The SHUTi group showed a significant decrease on the primary outcomes, the ISI (dbetween = -1.77, 95% CI = -2.23, -1.31) and the BIS (dbetween = -1.00, 95% CI = -1.32, -.68). Improvements were maintained among the completing SHUTi participants at the six-month nonrandomized follow-up. However, dropout attrition was high. CONCLUSION: Unguided Internet-based CBTi produced significant short-term improvements in sleep in patients with chronic insomnia. This highlights the benefits of making Internet-delivered CBTi programs available as a standard first-line treatment option in public health services. Nevertheless, the rate of dropout attrition (participants not completing post-assessment) in this trial limits the generalizability of the findings.
Authors: Øystein Vedaa; Susanne Hagatun; Håvard Kallestad; Ståle Pallesen; Otto R F Smith; Frances P Thorndike; Lee M Ritterband; Børge Sivertsen Journal: J Clin Sleep Med Date: 2019-01-15 Impact factor: 4.062
Authors: Jack D Edinger; J Todd Arnedt; Suzanne M Bertisch; Colleen E Carney; John J Harrington; Kenneth L Lichstein; Michael J Sateia; Wendy M Troxel; Eric S Zhou; Uzma Kazmi; Jonathan L Heald; Jennifer L Martin Journal: J Clin Sleep Med Date: 2021-02-01 Impact factor: 4.062
Authors: Tobias Wiklund; Peter Molander; Philip Lindner; Gerhard Andersson; Björn Gerdle; Elena Dragioti Journal: J Med Internet Res Date: 2022-04-29 Impact factor: 7.076
Authors: Susanne Hagatun; Øystein Vedaa; Allison G Harvey; Tine Nordgreen; Otto R F Smith; Ståle Pallesen; Odd E Havik; Frances P Thorndike; Lee M Ritterband; Børge Sivertsen Journal: Internet Interv Date: 2018-02-21
Authors: Håvard Kallestad; Øystein Vedaa; Jan Scott; Gunnar Morken; Ståle Pallesen; Allison G Harvey; Phil Gehrman; Frances Thorndike; Lee Ritterband; Tore Charles Stiles; Børge Sivertsen Journal: BMJ Open Date: 2018-08-30 Impact factor: 2.692