Online CBT for Insomnia - Is Telehealth CBTi as Effective as In-Person Treatment - Landscape

Online CBT for Insomnia: Is Telehealth CBTi as Effective as In-Person Treatment?

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Chronic insomnia, defined as dissatisfaction with sleep quality or duration, affects 10 to 15% of adults in the United States. Online Cognitive Behavioral Therapy (CBT) for insomnia is widely known. Cognitive Behavioral Therapy for Insomnia, also known as CBTi, is a scientifically researched insomnia treatment that addresses the physiological and psychological issues present in insomnia. The World Health Organization (WHO) recommends CBTi as the first-line therapy for insomnia. CBTi was traditionally offered in-person in the past, but due to the forced and adoption of telehealth and telemedicine services during the global pandemic, online CBT for insomnia is available. Recent publications have supported the use of CBTi for digital populations. Two are summarized for you below.

Recent Telehealth CBTi Research Article #1

A recently published study titled, Randomized Noninferiority Trial of Telehealth Delivery of Cognitive Behavioral Treatment of Insomnia Compared to In-Person Care 1 was published in The Journal of Clinical Psychiatry. It concluded that telehealth could be equally effective as an in-person treatment for delivering cognitive-behavioral therapy for insomnia. Involving 60 adult patients diagnosed with insomnia, the study’s results showed no significant difference in the Insomnia Severity Index (ISI) score between the in-person CBTi group and the telehealth CBTi group at a 3-month follow-up. The study’s authors, Philip Gehrman and colleagues, describe telehealth as a promising option for increasing access to treatment without loss of clinical gains. They stated,

Telehealth CBTi may produce clinically significant improvements in insomnia severity that are non-inferior to in-person treatment. CBTi is also associated with significant gains across a range of domains of functioning. Telehealth is a promising option for increasing access to treatment without loss of clinical gains.

Even though CBTi is the recommended treatment for insomnia, the researchers noticed that many clinicians are not yet trained in this treatment. For more information about how telehealth is comparable to in-person, brick-and-mortar care in many instances, see TBHI’s Telehealth Is As Good As In-Person Care? Consider the Telehealth Evidence.

Recent Telehealth CBTi Research Article #2

Yet more evidence is mounting to support CBTi as delivered through telehealth. Another supportive study of 65 adults was published in early 2021, titled, Telemedicine versus face-to-face delivery of cognitive-behavioral therapy for insomnia: a randomized controlled noninferiority trial 2 published through Oxford Academic. Author J Todd Arnedt, director of the Behavioral Sleep Medicine Program, and colleagues compared daytime functioning with chronic insomnia. They concluded, 

Telemedicine delivery of CBT for insomnia is not inferior to face-to-face for insomnia severity and yields similar improvements on other sleep and daytime functioning outcomes. Further, telemedicine allows for more efficient treatment delivery while not compromising therapeutic alliance.

The authors also concluded that telehealth has the potential to reduce healthcare disparities by extending access to unprivileged communities. Healthcare providers and payers are choosing telehealth CBT as a viable treatment option for insomnia and other sleep-related disorders; an alternative to in-person care. Read TBHI’s review article about the top 5 Best Light Therapy Boxes for insomnia for more technology that has been shown to help with insomnia.

References

1. Gehrman, P., Gunter, P., Findley, J., Frasso, R., Weljie, A. M., Kuna, S. T., & Kayser, M. S. (2021). Randomized Noninferiority Trial of Telehealth Delivery of Cognitive Behavioral Treatment of Insomnia Compared to In-Person Care. The Journal of Clinical Psychiatry, 82(5), 0-0.

2.  Arnedt, J. T., Conroy, D. A., Mooney, A., Furgal, A., Sen, A., & Eisenberg, D. (2021). Telemedicine versus face-to-face delivery of cognitive-behavioral therapy for insomnia: a randomized controlled noninferiority trial. Sleep, 44(1), zsaa136.

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