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Majd, N.R., Broström, A., Ulander, M., Lin, C.-Y., Griffiths, M.D. 
ORCID: 0000-0001-8880-6524, Imani, V., Ahorsu, D.K., Ohayon, M.M., Pakpour, A.H. and Lin, C.-Y.,
2020.
Original paper efficacy of a theory-based cognitive behavioral technique app-based intervention for patients with insomnia: randomized controlled trial.
Journal of Medical Internet Research, 22 (4): e158841.
ISSN 1439-4456
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Abstract
Background: Sleep hygiene is important for maintaining good sleep and reducing insomnia.
Objective: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients.
Methods: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time.
Results: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes.
Conclusions: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients.
| Item Type: | Journal article | ||||||
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| Publication Title: | Journal of Medical Internet Research | ||||||
| Creators: | Majd, N.R., Broström, A., Ulander, M., Lin, C.-Y., Griffiths, M.D., Imani, V., Ahorsu, D.K., Ohayon, M.M., Pakpour, A.H. and Lin, C.-Y. | ||||||
| Publisher: | JMIR Publications | ||||||
| Date: | 1 April 2020 | ||||||
| Volume: | 22 | ||||||
| Number: | 4 | ||||||
| ISSN: | 1439-4456 | ||||||
| Identifiers: |
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| Rights: | ©Nilofar Rajabi Majd, Anders Broström, Martin Ulander, Chung-Ying Lin, Mark D Griffiths, Vida Imani, Daniel Kwasi Ahorsu, Maurice M Ohayon, Amir H Pakpour. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.04.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included. | ||||||
| Divisions: | Schools > School of Social Sciences | ||||||
| Record created by: | Linda Sullivan | ||||||
| Date Added: | 01 Apr 2020 15:30 | ||||||
| Last Modified: | 01 Apr 2020 15:30 | ||||||
| URI: | https://irep.ntu.ac.uk/id/eprint/39531 |
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