The efficacy of digital cognitive behavioral therapy for insomnia in patients with insomnia disorder accompanied by anxiety and depressive symptoms: a randomized controlled trial
10.3760/cma.j.cn113661-20250307-00106
- VernacularTitle:数字化失眠认知行为治疗干预失眠障碍伴焦虑和抑郁症状的随机对照研究
- Author:
Min LIU
1
;
Ruhan YI
;
Ziliang HAN
;
Wuhong LIN
;
Min CHEN
;
Ping YAO
;
Peifeng YANG
;
Dongsheng LYU
Author Information
1. 内蒙古自治区精神卫生中心 内蒙古自治区第三医院 内蒙古自治区脑科医院，呼和浩特 010010
- Publication Type:Journal Article
- Keywords:
Sleep initiation and maintenance disorders;
Anxiety and depressive symptoms;
Digital cognitive behavioral therapy for insomnia;
Efficacy
- From:
Chinese Journal of Psychiatry
2025;58(8):630-638
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and treatment adherence of digital cognitive behavioral therapy for insomnia (dCBT-I) in patients with insomnia disorder accompanied by anxiety and depressive symptoms, and to provide empirical evidence for its clinical application.Methods:From December 2023 to December 2024, 102 patients with insomnia disorder accompanied by anxiety and depressive symptoms were recruited from the outpatient department of Inner Mongolia Brain Hospital and randomly assigned to either the dCBT-I group ( n=56) or the digital sleep hygiene education (dSHE) group ( n=46). The dCBT-I group received a 4-week intervention comprising 5 core modules, while the dSHE group received 4 weeks of digital sleep hygiene education. Both groups received weekly guidance from clinical psychologists. Subjective sleep quality (Insomnia Severity Index, ISI), anxiety (Hamilton Anxiety Scale, HAMA), and depressive symptoms (17-item Hamilton Depression Scale, HAMD 17) were assessed at baseline, week 4, week 8, and week 12. Objective sleep parameters (polysomnography, PSG) and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status, RBANS) were evaluated at baseline and week 4. Linear mixed-effects model was used to analyze the effects of group, timepoint, and their interaction on outcome measures, after controlling medication history, age, sex, education level, ethnicity, and marital status as covariates. Results:A total of 76 patients (dCBT-I: n=42; dSHE: n=34) completed the 4-week intervention, yielding a treatment adherence rate of 74.5%(76/102). At weeks 4, 8, and 12, the dCBT-I group demonstrated significantly lower scores on the ISI, HAMA, and HAMD 17 scales compared to the dSHE group (β=-1.70--0.66, t=-15.38--6.21, all P<0.05), along with higher rates of medication reduction (χ 2=16.40, 9.22, 6.66, all P<0.05). No significant differences were observed in PSG parameters between the two groups. However, the dCBT-I group demonstrated significant improvements in RBANS subdomains, including immediate memory, language function, and delayed memory (β=0.45, 0.86, 1.43, t=3.09, 2.67, 4.36, all P<0.05). Conclusion:dCBT-I is an effective and well-adhered intervention for patients with insomnia disorder accompanied by anxiety and depressive symptoms, warranting broader clinical implementation.
