Original paper efficacy of a theory-based cognitive behavioral technique app-based intervention for patients with insomnia: randomized controlled trial

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
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:
NumberType
10.2196/15841DOI
1313090Other
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: http://irep.ntu.ac.uk/id/eprint/39531

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