Internet-based cognitive behavioural therapy for insomnia among primary care patients : effectiveness and satisfaction with treatment

• Main Author: Nína Guðrún Guðjónsdóttir 1994-
• Other Authors: Háskólinn í Reykjavík
• Format: Thesis
• Language: English
• Published: 2019
• Subjects: Klínisk sálfræði; Meistaraprófsritgerðir; Svefnleysi; Hugræn atferlismeðferð; Clinical psychology; Sleep disorders; Isi; Iceland
• Online Access: http://hdl.handle.net/1946/32934

Insomnia is a commonly encountered condition in primary care, associated with significant medical, psychological and socioeconomic consequences. It is most often managed with hypnotic prescriptions and sleep hygiene advice even though cognitive behavioural therapy for insomnia (CBT-I) is the recommended treatment. CBT-I is not readily accessible but that could be solved by delivering the treatment through the Internet in primary care. This study aimed at evaluating the effectiveness of a six-week Internet-based CBT-I in primary care and patients’ satisfaction. Participants were 177 primary care patients seeking help for insomnia and referred by general practitioners at two primary care clinics in Iceland. There were 101 patients that began treatment and 35 completed it, leaving dropout rate at 65.35%. Data was available for 31 patients of the 35 who completed the treatment. The patients were asked to complete sleep diaries daily throughout therapy, the Insomnia Severity Index before and after therapy and the Epworth Sleepiness Scale every week. After treatment, they were asked to answer an especially designed Treatment Satisfaction Questionnaire. The treatment resulted in significant improvements on all sleep diary variables, hypnotic drug use and insomnia severity. The effect sizes ranged from small (ESS=-0.19) to large (ISI=-1.34). Patients were overall satisfied with the program. These findings provide preliminary evidence that Internet-based CBT-I is an effective, feasible and acceptable treatment option to insomnia patients in primary care and offers the promise of increased access and availability of non-pharmacological treatment options in primary care. Although, adjustments are needed, considering suboptimal adherence and high dropout among primary care patients.