Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Chan KL (1), Pau HYN (1), Poon FOS (1), Lam LHB (1), Lam CBI (2), Chan KSK (3)
Affiliation :
(1) Integrated Mental Health Services, Baptist Oi Kwan Social Service, (2) Department of Early Childhood Education, The Education University of Hong Kong, (3) Department of Psychology, The Education University of Hong Kong
Introduction :
Insomnia is a common sleep disorder that affects a significant portion of the Hong Kong population. It can have negative impact on emotional well-being, daytime functioning, cognitive abilities, and physical health. It can also increase the risk of developing mental disorders including depression and anxiety.
Objectives :
The present study aimed to conduct a randomized controlled trial to examine the efficacy of an internet-based self-help cognitive behavioral therapy for insomnia (CBT-I) in reducing insomnia severity among individuals with sub-threshold insomnia in Hong Kong.
Methodology :
In this study, we conducted a two-arm parallel randomized controlled trial, with participants randomly assigned to either the seven-week CBT-I intervention group or the waitlist control group. The CBT-I comprised an introductory module followed by six weekly modules incorporating key components of CBT-I, including sleep hygiene education, stimulus control, sleep restriction, relaxation training, and cognitive therapy. The waitlist control group did not receive any intervention during the first seven weeks. Both groups completed research assessments at baseline (T0), immediately after intervention (T1), and four weeks afterwards (T2).
Result & Outcome :
Participant recruitment took place from October to December 2022, resulting in the enrollment of 358 eligible participants who completed baseline assessments. A multilevel model predicting insomnia symptoms showed that the main effect of group was non-significant, but the main effect of time was significant at T1 (B = -2.46, p < 0.001, 95% CI = [-3.09, -1.83]) and T2 (B = -2.84, p < 0.001, 95% CI = [-3.49, -2.19]). In addition, there was a significant group X time interaction effect at T1 (B = -2.96, p < 0.001, 95% CI = [-3.92, -2.01]) and T2 (B = -2.99, p < 0.001, 95% CI = [-3.97, -2.02]). Between-group comparisons revealed a significant group difference, with the intervention group showing lower insomnia severity at T1 (t(756.67) = -6.61, p < 0.001, Cohen's d = 1.09, 95% CI = [-4.01, -2.17]) and T2 (t(773.70) = -6.53, p < 0.001, Cohen's d = 1.10, 95% CI = [-4.06, -2.18]). The results of this two-arm RCT suggest that online self-help CBT-I is effective for adults with subthreshold insomnia. Given its low cost, high accessibility, and minimal therapist involvement, it is recommended as a first-step intervention.
