Authors (including presenting author) :
Chan KL (1), Poon FOS (1), Lam LHB (1), Chan KSK (2), Lam CBI (3)
Affiliation :
(1) Integrated Mental Health Services, Baptist Oi Kwan Social Service, (2) Department of Psychology, The Education University of Hong Kong, (3) Department of Early Childhood Education, The Education University of Hong Kong
Introduction :
Insomnia is a common sleep disorder that affects a significant portion of the Hong Kong population and can have negative impacts on daytime functioning, cognitive abilities, and physical health. It has also been linked to an increased risk of developing mental health disorders such as depression and anxiety.
Objectives :
The current study aimed to examine the efficacy of an online self-help cognitive behavioral therapy for insomnia (CBT-I) intervention in reducing insomnia severity among individuals with sub-threshold insomnia in Hong Kong, compared to a waitlist control group.
Methodology :
The study design included a two-arm parallel randomized controlled trial, with participants randomly assigned to either the seven-week CBT-I intervention or the waitlist control group. The CBT-I intervention 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 the intervention for the first seven weeks, after which they completed a post-intervention assessment and a follow-up assessment four weeks later.
Result & Outcome :
Participant recruitment for the present study took place from October to December 2022, resulting in the enrollment of 358 eligible participants who completed baseline assessments. Initial analyses were conducted using data from the baseline and post-intervention time points. Using a multilevel model predicting insomnia symptoms showed no significant for the fixed effects of treatment conditions. However, a significant association was observed at the week 7 follow-up between time and insomnia severity [B = -2.56, S.E. = 0.39, p < 0.001, 95% CI (-3.32 to -1.80)]. The time X group interaction also demonstrated a significant association [B = -2.48, p < 0.001, 95% CI (-3.62 to -1.33)]. Between-group comparisons at the week 7 follow-up revealed a significant difference in favor of the treatment group [t(491.50) = -5.15, p < 0.001, Cohen's d = 1.01, 95% CI (-3.89 to -1.74)]. The results of this two-arm RCT suggest that unguided online CBT-I is effective in sub-clinical adults. Given its low cost, high accessibility, and minimal therapist involvement, it is recommended as a first-step intervention.
