Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis.

Psychother Psychosom

Clinical Psychology Service, Kwai Chung Hospital, Hong Kong, SAR, China.

Published: September 2012

AI Article Synopsis

  • The study evaluates the effectiveness of computerised cognitive behavioural therapy for insomnia (CCBT-I) through a meta-analysis of selected randomised controlled trials.
  • Out of 533 papers reviewed, 6 trials showed significant improvements in various sleep quality metrics, with the treatment being well-received and adopted by a high percentage of participants (78% adherence).
  • CCBT-I is considered a mildly to moderately effective self-help therapy for insomnia, positioning it as a valuable option in the stepped care approach for treating sleep disorders.

Article Abstract

Background: Computerised cognitive behavioural therapy (CCBT) is an innovative mode of delivering services to patients with psychological disorders. The present paper uses a meta-analysis to systematically review and evaluate the effectiveness of CCBT for insomnia (CCBT-I).

Method: A comprehensive search was conducted on 7 databases including MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Library, Social Sciences Citation Index and PubMed (up to March 2011). Search terms covered 3 concepts: (1) [internet, web, online, computer-aided, computer-assisted, computer-guided, computerized OR computerised] AND (2) [CBT, cognitive therapy, behavio(u)ral therapy OR behavio(u)r therapy] AND (3) [insomnia, sleep disorders OR sleeping problem].

Results: 533 potentially relevant papers were identified, and 6 randomised controlled trials (RCTs) that met the selection criteria were included in the review and analysis. Two RCTs were done by the same group of investigators (Ritterband and colleagues) using the same internet programmes. Post-treatment mean differences between groups showed that the effects of CCBT-I on sleep quality, sleep efficiency, the number of awakenings, sleep onset latency and the Insomnia Severity Index were significant, ranging from small to large effect sizes. However, effects on wake time after sleep onset, total sleep time and time in bed were non-significant. On average, the number needed to treat was 3.59. The treatment adherence rate for CCBT-I was high (78%).

Conclusion: The results lend support to CCBT as a mildly to moderately effective self-help therapy in the short run for insomnia. CCBT-I can be an acceptable form of low-intensity treatment in the stepped care model for insomnia.

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Source
http://dx.doi.org/10.1159/000335379DOI Listing

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