Cognitive Behavioral Therapy
The effect of e-aid cognitive behavioral therapy in treating chronic insomnia disorder: an open-label randomized controlled trial
Zhang Bin, Zhang Lili, Chen Shiya, Luo Xian, Paudel Dhirendra, Lin Qiuyan, Yan Caiping, Fang Leqin, Zhao Yuhan
Published 2019-12-05
Cite as Chin J Psychiatry, 2019,52(6): 373-378. DOI: 10.3760/cma.j.issn.1006-7884.2019.06.003
Abstract
ObjectiveTo investigate the efficacy and compliance of e-aid cognitive behavioral therapy for insomnia (eCBTI) in Chinese patients with chronic insomnia disorder.
MethodsIn a 4-week open-label randomized controlled study, by using the simple random method, 190 patients with chronic insomnia disorder who met the study criteria were divided into the eCBTI group (95 cases) and the waiting-list group (95 cases) by 1∶1. The eCBTI group received 4 weeks of treatment including 5 CBTI core modules. The waiting-list group was evaluated by sleep dairy and insomnia severity index (ISI) at the enrollment and weeks 4. The recovery index was defined by sleep efficiency (SE)>85% and ISI<8 separately. T test was used to compare the sleep parameters between two groups, and χ2 test was used to compare the remission rate.
ResultsFifty-five patients in eCBTI group and 78 patients of the waiting-list group completed the entire treatment and all of evaluations. After 4 weeks of treatment, the score-reducing rate of following index: sleep efficiency (11.6%±3.9% vs. 2.9%±1.1%, t=4.63, P=0.036), sleep onset latency (-57.0%±-14.7% vs. -19.8%±-8.5%, t=13.44, P<0.01), number of awakenings (-43.4%±-13.0% vs. -12.2%±-6.1%, t=3.73, P=0.042) and ISI scores (-49.7%±-15.7% vs. -16.4%±-8.3%, t=11.72, P<0.01) in the eCBTI group were significantly better than those in the waiting-list group. In addition, when SE>85% was used as the recovery index for insomnia, the recovery rate of eCBTI group was 67.3%, and that of waiting-list group was 26.9% (χ2=21.36, P<0.01). when ISI<8 was used as the recovery index for insomnia, the recovery rate of eCBTI group was 43.6%, and that of waiting-list group was 6.4% (χ2=26.22, P<0.01).
ConclusionThis study supported that eCBTI had good therapeutic effects on Chinese patients with chronic insomnia disorder, but the treatment compliance should be further improved.
Key words:
Sleep initiation and maintenance disorders; E-aid cognitive behavioral therapy for insomnia; Randomized controlled trial
Contributor Information
Zhang Bin
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Zhang Lili
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Chen Shiya
The Psychological Counseling Center, Zhongshan the Third People′s Hospital, Zhongshan 528400, China
Luo Xian
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Paudel Dhirendra
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Lin Qiuyan
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Yan Caiping
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Fang Leqin
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China
Zhao Yuhan
Department of Psychiatry, Southern Medical University, Nanfang Hospital, Guang Zhou 510515, China