Enhancing sleep and mood in depressed adolescents: A randomized trial on nurse-led digital cognitive behavioral therapy for insomnia.

Background: Despite the effectiveness of digital cognitive behavior therapy for insomnia (dCBT-I) in treating comorbid insomnia and depression, its accessibility and high dropout rates among adolescents and young adults remain significant limitations. A potential solution could be nurse-led dCBT-I. This study evaluates the feasibility and efficacy of nurse-led dCBT-I in reducing insomnia symptoms and improving mood in adolescents and young adults with depression.

Aims: Our objective was to evaluate the feasibility and effectiveness of a nurse-led dCBT-I in reducing insomnia severity among adolescents and young adults with depression.

Methods: A parallel-group randomized controlled trial involved 40 adolescents and young adults aged 14 to 24 with major depressive disorder and insomnia. They were assigned to receive either a nurse-led 6-week dCBT-I or usual care. The study evaluated outcomes such as insomnia severity, depression severity, and sleep parameters. Measurements were taken at baseline, immediately after the intervention (6 weeks), and during a follow-up at 18 weeks.

Results: The intention-to-treat analysis was performed using a generalized linear mixed model (GLMM). Results indicated that, compared to the control group, participants in the intervention group exhibited a significant reduction in insomnia severity at the 18-week follow-up, with a large effect size (Cohen's d = -0.965, p < 0.001). Additionally, the intervention group demonstrated a significant decrease in depression severity both at the end of the intervention (Cohen's d = -0.686, p = 0.001) and at the 18-week follow-up (Cohen's d = -0.508, p = 0.011), indicating a medium effect size.

Conclusions: Nurse-led dCBT-I is an effective treatment for adolescents and young adults with depression and insomnia.