Abstract
Purpose
The purpose of the study was to compare the efficacy of group-based therapy (GT) and
email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I)
with the wait-list (WL) control group in youths.
Methods
The study involved an assessor-blind, parallel group randomized controlled trial in
youths meeting the diagnostic criteria for insomnia disorder. Participants were randomized
to one of the three groups (8-week GT, 8-week ESH, or WL). Participants in all three
groups were assessed at baseline and after treatment (week 9 for the WL group). The
two treatment groups were additionally assessed at one month and six months after
the intervention. Treatment effects were examined using linear mixed models.
Results
A total of 135 youths (mean age: 20.0 ± 2.5 years, female: 67.4%) were recruited.
After treatment, both active treatment groups showed significant improvements in insomnia
symptoms (GT vs. WL: Cohen's d = −1.03, ESH vs. WL: d = −.63), less presleep arousal (d = −.52 to −1.47), less sleep-related dysfunctional belief (d = −.88 to −1.78), better sleep hygiene practice (d = −.79 to −.84), and improved daytime functioning (d = −.56 to −.96) compared with the WL group. In addition, GT outperformed ESH in improving
maladaptive sleep-related beliefs and mood symptoms at post-treatment and 6-month
follow-up. A reduction of suicidality with moderate effect size favoring GT emerged
at 6-month follow-up.
Discussion
Our findings suggested that both group-based and email-delivered CBT-I were effective
in treating youth insomnia, but group-based CBT-I showed superior effects on reducing
maladaptive beliefs and mood symptoms.
Keywords
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Article info
Publication history
Published online: February 03, 2022
Accepted:
November 1,
2021
Received:
May 9,
2021
Footnotes
Conflicts of interest: The authors have no conflicts of interest to disclose.
Clinical trials registration: US National Institutes of Health (NCT03522701).
Identification
Copyright
© 2021 Society for Adolescent Health and Medicine. All rights reserved.