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For older people with insomnia, digital cognitive behavioral therapy can serve as a first-line choice to enhance sleep and mental health.
Researchers have found that digital cognitive behavioral therapy (dCBT) is highly effective in mitigating the symptoms of insomnia, anxiety, and depression in adults aged 65 years and above, according to a recent study. The prevalence of insomnia among older adults is reported to be as high as 40%, with limited accessibility to recommended treatment options such as CBT. The study examined the usefulness of fully-automated dCBT in this population.
The study analyzed individual volunteer data from previous randomized controlled trials of dCBT for insomnia, involving a total of 486 subjects. The participants were divided into two groups, with one receiving access to dCBT and the other serving as a control group. Standardized measurements were used to assess depression, insomnia, and anxiety endpoints across the studies. Scores were standardized into z-scores.
The impact of the treatment on combined sleep, depression, and anxiety outcomes was assessed through mixed-effects models at post-treatment and follow-up. In studies utilizing the Sleep Condition Indicator (SCI)-8, insomnia remission rates between groups were evaluated using chi-squared tests at post-treatment. The results showed that dCBT led to remarkable improvements in sleep quality, depression symptoms, and anxiety symptoms compared to the control group, both immediately after treatment and during follow-up.
Participants in the dCBT group were also more likely to achieve remission of insomnia compared to the control group. These findings highlight the potential of dCBT as a first-line therapeutic choice for insomnia management, contributing to better sleep and overall mental health. In comparison to the control group, digital CBT resulted in considerably better improvements in combined sleep (ds ≤ -1.34, ps < .001) and depression (ds ≤ -0.35, ps ≤ .001) outcomes both at post-treatment and follow-up.
Regarding the combined anxiety outcome, dCBT demonstrated better improvements at post-treatment (d = -0.30, p = .004). Furthermore, participants randomized to dCBT had a higher likelihood of attaining remission of insomnia (60% vs. 16%) at post-treatment. The study underscores the importance of accessible and scalable treatment options for older adults, as dCBT provides a means to receive guideline-concordant treatment remotely. By expanding the availability of effective interventions, this research has the potential to improve the well-being and quality of life of older adults struggling with insomnia and related mental health issues.
Sleep
0352 Digital cognitive behavioral therapy in treating insomnia in older adulthood: A sub-analysis using individual participant data
Kathryn Tarnai et al.
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