Mental Health Improved with Online Therapy for Insomnia
In paranoia and hallucinations, insomnia was a mediator of change.
HealthDay News — For university students with insomnia, digital cognitive behavioral therapy (CBT) is associated with reductions in insomnia, paranoia, and hallucinations, according to a study published in The Lancet Psychiatry.
Daniel Freeman, PhD, from the University of Oxford in the United Kingdom, and colleagues conducted a single-blind trial at 26 universities. A total of 3755 students with insomnia were randomized to receive digital CBT for insomnia (1891 participants) or usual care (1864 participants), and were assessed online at weeks 0, 3, 10 (end of treatment), and 22.
The researchers found that the sleep intervention correlated with reductions in insomnia, paranoia, and hallucinations at 10 weeks, compared with usual practice (adjusted difference, 4.78, −2.22, and −1.58, respectively). In paranoia and hallucinations, insomnia was a mediator of change. There were no reports of adverse events.
"To our knowledge, this is the largest randomized controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems," the authors write. "Whether the results generalize beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision."
Disclosures: Several authors disclosed financial ties to pharmaceutical, publishing, and health care companies, including Sleepio and Big Health Ltd., which provided the sleep treatment program to trial participants at no cost.
Freeman D, Sheaves B, Goodwin GM, et al. The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis [published online September 6, 2017]. Lancet Psychiatry. doi:10.1016/S2215-0366(17)30328-0