Cognitive factors and processes in models of insomnia: A systematic review

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)

Published: June 26, 2023

Summary Cognition is central to the experience of insomnia. Although unhelpful thoughts about and around insomnia are a primary treatment target cognitive behaviour therapy for insomnia, constructs termed conceptualised differently in different theories proposed over past decades. In search consensus thinking, current systematic review identified factors processes featured theoretical models mapped any commonality between models. We systematically searched PsycINFO PubMed published articles on development, maintenance remission from inception databases February, 2023. A total 2458 records were title abstract screening. Of these, 34 selected full‐text assessment 12 included analysis data synthesis following Preferred Reporting Items Systematic Reviews Meta‐Analyses (PRISMA) guidelines. nine distinguishable 1982 2023 extracted 20 these models; 39 if sub‐factors counted. After assigning similarity ratings, we observed high degree overlap despite apparent differences terminologies measurement methods. As result, highlight shifts thinking cognitions associated with discuss future directions.

Language: Английский

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Disseminating cognitive behavioural therapy (CBT) for insomnia at scale: capitalising on the potential of digital CBT to deliver clinical guideline care

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)

Published: Aug. 29, 2023

Summary Cognitive behavioural therapy (CBT) is the recommended first‐line treatment for insomnia. However, guideline care very seldom available and most patients receive no treatment, or less effective second‐line pharmacotherapy sleep hygiene, neither of which are evidence‐based chronic The primary challenge CBT has been supply. There not enough therapists to meet enormous demand. We must accelerate clinician training, but this approach can never be sufficient, even with abbreviated, efficient therapies. Fortunately, however, landscape also changed dramatically. Fully‐automated digital (dCBT) emerged as a safe, effective, scalable delivery format. dCBT software only, so it disseminated readily widely medication. Moreover, integrated into services. Just medications delivered through health professionals systems, approved programmes same. an ecosystem psychologically‐based should necessitate medical prescription model. Our proposed stepped framework, comprises both population clinical service initiatives, enabling universal access diverse ways in may (in‐person, face‐to‐face, using telehealth, group therapy, digitally) operate congruently efficiently optimise people at all levels complexity need. With safe clinically products now set become established treatments, clearly differentiated from wellness apps, there potential rapidly transform insomnia services and, first time, deliver international scale.

Language: Английский

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Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States

SLEEP, Journal Year: 2020, Volume and Issue: 44(4)

Published: Nov. 5, 2020

Abstract Study Objectives To examine the cost-effectiveness and potential net monetary benefit (NMB) of a fully automated digital cognitive behavioral therapy (CBT) intervention for insomnia compared with no treatment in United States (US). Similar relative comparisons were made pharmacotherapy clinician-delivered CBT (individual group). Methods We simulated Markov model 100,000 individuals using parameters calibrated from literature including direct (treatment) indirect costs (e.g. insomnia-related healthcare expenditure lost workplace productivity). Health utility estimates converted into quality-adjusted life years (QALYs) one QALY was worth $50,000. Simulated randomized equally to five arms (digital CBT, pharmacotherapy, individual group or treatment). Sensitivity assessed by bootstrapping parameters. Cost expressed 2019 US dollars. Results Digital cost beneficial when had positive NMB $681.06 (per over 6 months). Bootstrap sensitivity analysis demonstrated that 94.7% simulations. Relative other treatments, most cost-effective because it generated smallest incremental ratio (−$3,124.73). Conclusions followed CBT. It is financially prudent societal perspective utilize treat at population scale.

Language: Английский

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eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis

JMIR Mental Health, Journal Year: 2021, Volume and Issue: 9(2), P. e31116 - e31116

Published: Nov. 5, 2021

Pregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising accessible treatment alternative to face-to-face interventions.The objective of this systematic review meta-analysis determine the effectiveness in preventing treating insomnia during pregnancy. Secondary aims are identify demographic intervention moderators effectiveness.A total 5 databases (PsycINFO, Medline, CINAHL, Embase, Cochrane) were searched from inception May 2021. Terms related eHealth, pregnancy, randomized controlled trials (RCTs), included. RCTs pilot included if they reported prevention or pregnant women. Study screening, data extractions, quality assessment conducted independently by 2 reviewers 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, Beatrice Valmana). Random-effects meta-analyses pooled effect sizes on prenatal mental health. Meta-regression analyses potential moderators.In total, 17 studies that assessed changes depression (11/17, 65%), anxiety (10/17, 59%), (3/17, 18%). Several both symptoms as outcomes (7/17, 41%). The results indicated showed small moderate size With exception type outcome depressive symptoms, where mindfulness outperformed other types, no significant detected.eHealth resource However, more necessary ways increase efficacy population.PROSPERO (International Prospective Register Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954.

Language: Английский

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Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomised controlled trial from pregnancy to 2 years postpartum

Psychological Medicine, Journal Year: 2021, Volume and Issue: unknown, P. 1 - 11

Published: July 7, 2021

Abstract Background Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these Methods two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were 1:1 to CBT or attention- time-matched control. All participants received 1 h telephone session automated multimedia emails from third trimester until 6 months postpartum. Outcomes assessed with validated instruments at gestation weeks 30 (baseline) 35 (pregnancy endpoint), 1.5, 3, (postpartum 12 24. Results In total, 163 eligible (age M ± s.d. = 33.35 3.42) randomised. The was well accepted, no reported adverse effect. Intention-to-treat analyses showed that compared control, receiving associated lower insomnia severity (two primary outcomes), sleep-related impairment endpoint ( p values ⩽ 0.001), as 24 ranges 0.012–0.052). Group differences across first year non-significant. Participants elevated symptoms baseline benefitted substantially more v. control), including having significantly throughout year. depression anxiety Conclusions A efficacious buffering against 2-year postpartum, especially individuals pregnancy. holds promise implementation into routine perinatal care.

Language: Английский

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Associations between insomnia and pregnancy and perinatal outcomes: Evidence from mendelian randomization and multivariable regression analyses

PLoS Medicine, Journal Year: 2022, Volume and Issue: 19(9), P. e1004090 - e1004090

Published: Sept. 6, 2022

Insomnia is common and associated with adverse pregnancy perinatal outcomes in observational studies. However, those associations could be vulnerable to residual confounding or reverse causality. Our aim was estimate the association of insomnia stillbirth, miscarriage, gestational diabetes (GD), hypertensive disorders (HDP), depression, preterm birth (PTB), low/high offspring birthweight (LBW/HBW).

Language: Английский

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Understanding the Online Social Support Dynamics for Postpartum Depression

Published: April 19, 2023

Postpartum depression (PPD) is one of the most prevalent mental health disorder following childbirth. Mothers utilize social media and online forums throughout postpartum to seek support. In this paper, we aim gain a comprehensive understanding topics naturally occurring discussions support dynamics associated with PPD. We qualitatively analyze posts comments from three communities corresponding well-known platforms (Reddit, What expect, Babycenter). discovered that share common themes discussion include causes, stressors, symptoms, coping mechanisms for Seeking both informational emotional through venting storytelling was prevalent, seeking more in Reddit than other two communities. provide recommendations future research design considerations based on pervasive help-seeking approaches.

Language: Английский

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The gap between statistical and clinical significance: time to pay attention to clinical relevance in patient-reported outcome measures of insomnia

BMC Medical Research Methodology, Journal Year: 2024, Volume and Issue: 24(1)

Published: Aug. 8, 2024

Appropriately defining and using the minimal important change (MIC) clinically difference (MCID) are crucial for determining whether results significant. The aim of this study is to survey status randomized controlled trials (RCTs) insomnia interventions assess inclusion interpretation MIC/MCID values.

Language: Английский

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Technology-based Cognitive Behavioral Therapy Interventions

Psychiatric Clinics of North America, Journal Year: 2024, Volume and Issue: 47(2), P. 399 - 417

Published: March 23, 2024

Language: Английский

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Perinatal Insomnia and Mental Health: a Review of Recent Literature

Current Psychiatry Reports, Journal Year: 2020, Volume and Issue: 22(12)

Published: Oct. 26, 2020

Language: Английский

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