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Does adjunctive digital CBT for insomnia improve clinical outcomes in an improving access to psychological therapies service?

Authors :
Stott R
Pimm J
Emsley R
Miller CB
Espie CA
Source :
Behaviour research and therapy [Behav Res Ther] 2021 Sep; Vol. 144, pp. 103922. Date of Electronic Publication: 2021 Jul 01.
Publication Year :
2021

Abstract

Background: Insomnia has a bidirectional relationship with broader mental health functioning, including anxiety and depression. Yet, poor sleep has historically been neglected as a specific treatment target in mental health programmes (Freeman, Sheaves, Waite, Harvey, & Harrison, 2020).<br />Method: All patients over a 12-month period entering the Improving Access to Psychological Therapies (IAPT) service endorsing a 'poor sleep' questionnaire item at assessment, were offered a self-guided digital sleep intervention, Sleepio, in addition to routine care. Sleepio is based on the principles of Cognitive Behavioural Therapy for Insomnia (CBT-I). Propensity score matching established a non-Sleepio control group matched on demographic and baseline clinical measures.<br />Results: Patients who signed up to Sleepio (n = 510) achieved significantly better outcomes on core clinical metrics (PHQ-9, GAD-7, WSAS) than controls. IAPT recovery rates <superscript>1</superscript> (on PHQ-9 and GAD-7) were 64.7%, versus 58% in the control group. Duration of clinical contact time was marginally elevated overall in the Sleepio group but by less than 1 h CONCLUSIONS: Significant clinical benefit was associated with the introduction of an evidence-based digital sleep intervention alongside other mental health interventions for depression and anxiety. Widespread deployment was achieved with immediate availability, minimal additional clinical time or staff training. This approach provides a feasible and highly scalable model for improving mental health outcomes in clinical services.<br /> (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Details

Language :
English
ISSN :
1873-622X
Volume :
144
Database :
MEDLINE
Journal :
Behaviour research and therapy
Publication Type :
Academic Journal
Accession number :
34246110
Full Text :
https://doi.org/10.1016/j.brat.2021.103922