TY  - JOUR
AU  - Rajabi Majd, Nilofar
AU  - Broström, Anders
AU  - Ulander, Martin
AU  - Lin, Chung-Ying
AU  - Griffiths, Mark D
AU  - Imani, Vida
AU  - Ahorsu, Daniel Kwasi
AU  - Ohayon, Maurice M
AU  - Pakpour, Amir H
PY  - 2020
DA  - 2020/4/1
TI  - Efficacy of a Theory-Based Cognitive Behavioral Technique App-Based Intervention for Patients With Insomnia: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e15841
VL  - 22
IS  - 4
KW  - app-based intervention
KW  - cognitive behavioral therapy, insomnia
KW  - sleep hygiene
KW  - theory of planned behavior
AB  - Background: Sleep hygiene is important for maintaining good sleep and reducing insomnia. Objective: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients. Methods: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time. Results: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes. Conclusions: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients. Trial Registration: ClinicalTrials.gov NCT03605732; https://clinicaltrials.gov/ct2/show/NCT03605732 
SN  - 1438-8871
UR  - http://www.jmir.org/2020/4/e15841/
UR  - https://doi.org/10.2196/15841
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32234700
DO  - 10.2196/15841
ID  - info:doi/10.2196/15841
ER  -