Guided internet cognitive behavioral therapy for insomnia compared to a control treatment - a randomized trial
Open accessAbstract
AIM: To evaluate if internet-delivered Cognitive Behavioral Therapy for insomnia (ICBT-i) with brief therapist support outperforms an active control treatment. METHOD: Adults diagnosed with insomnia were recruited via media (n = 148) and randomized to either eight weeks of ICBT-i or an active internet-based control treatment. Primary outcome was the insomnia severity index (ISI) assessed before and after treatment, with follow-ups after 6 and 12 months. Secondary outcomes were use of sleep medication, sleep parameters (sleep diary), perceived stress, and a screening of negative treatment effects. Hierarchical Linear Mixed Models were used for intent-to-treat analyses and handling of missing data. RESULTS: ICBT-i was significantly more effective than the control treatment in reducing ISI (Cohen's d = 0.85), sleep medication, sleep efficiency, sleep latency, and sleep quality at post-treatment. The positive effects were sustained. However, after 12 months the difference was no longer significant due to a continuous decrease in ISI among controls, possibly due to their significantly higher utilization of insomnia relevant care after treatment. Forty-six negative effects were reported but did not differ between interventions. CONCLUSIONS: Supported ICBT-i is more effective than an active control treatment in reducing insomnia severity and treatment gains remain stable one year after treatment.
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The numbers of messages sent between therapists and participants were at a similar level as those reported by Kaldo et al. (2015) and Blom et al. (2015a).
“Furthermore, the numbers of messages sent between the therapists and the participants were at a similar level as those reported by Kaldo et al. (2015) and Blom et al. (2015a).”
From Feasibility and preliminary efficacy of guided internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial (2021) · cites this paper as Kaldo et al. (2015)
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“The score for satisfaction with the iCBT-i, as reported in the CSQ-8, was 24.1, which is good and comparable to previous studies on internet-based CBT-i, which reported between 23.1 and 27.3 for the same measure (Blom et al., 2015a; Blom et al., 2015b; Kaldo et al., 2015).”
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- Authors
- Kaldo, V., Jernelöv, S., Blom, K., Ljótsson, B., Brodin, M., Jörgensen, M., Kraepelien, M., Rück, C., & Lindefors, N.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Kaldo, Viktor
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 71
- Pages
- 90-100
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1771931246
- Cited by
- 132
- References
- 48
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 11 · 2023: 11 · 2022: 13 · 2021: 14 · 2020: 24 · 2019: 15 · 2018: 5 · 2017: 7 · 2016: 14 · 2015: 4
- FWCI
- 14.92
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Söderström-Königska Foundation (SLS-156621)
- AFA Sickness Insurance Research Fund (2999/09-721)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- insomnia, internet-based cognitive behavioral therapy, Insomnia Severity Index, therapist support, sleep medication use, sleep efficiency, sleep latency, sleep quality, perceived stress, treatment effects, long-term treatment outcomes
- MeSH terms
- Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Patient Compliance, Professional-Patient Relations, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Patient Satisfaction, Outcome Assessment, Health Care, Internet
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