Daniel Kwasi Ahorsu1, Chung-Ying Lin1, Vida Imani2, Per Carlbring3, Annette Nygårdh4, Anders Broström5, Kyra Hamilton6, Amir H Pakpour7. 1. Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. 2. Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 3. Department of Psychology, Stockholm University, Stockholm, Sweden. 4. Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden. 5. Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden. 6. School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia. 7. Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. Electronic address: Pakpour_Amir@yahoo.com.
Abstract
PURPOSE:Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors. METHODS:Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models. RESULTS: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes. CONCLUSION: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
RCT Entities:
PURPOSE:Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors. METHODS:Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models. RESULTS: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes. CONCLUSION: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
Authors: Sara Fazeli; Isa Mohammadi Zeidi; Chung-Ying Lin; Peyman Namdar; Mark D Griffiths; Daniel Kwasi Ahorsu; Amir H Pakpour Journal: Addict Behav Rep Date: 2020-10-22
Authors: Sadia Malik; Irfan Ullah; Muhammad Irfan; Daniel Kwasi Ahorsu; Chung-Ying Lin; Amir H Pakpour; Mark D Griffiths; Ibad Ur Rehman; Rafia Minhas Journal: BMC Public Health Date: 2021-04-30 Impact factor: 3.295
Authors: Chung-Ying Lin; Zainab Alimoradi; Narges Ehsani; Maurice M Ohayon; Shun-Hua Chen; Mark D Griffiths; Amir H Pakpour Journal: Healthcare (Basel) Date: 2022-01-04