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Computerised Cognitive Behavioural Therapy for Insomnia: A Systematic Review and Meta-Analysis
Psychotherapy and Psychosomatics, 05/16/2012
Evidence Based Medicine
Clinical Article
Cheng SK et al. – The results lend support to computerised cognitive behavioural therapy (CCBT) as a mildly to moderately effective self–help therapy in the short run for insomnia. CCBT for insomnia can be an acceptable form of low–intensity treatment in the stepped care model for insomnia.
Methods- A comprehensive search was conducted on 7 databases including MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Library, Social Sciences Citation Index and PubMed (up to March 2011).
- Search terms covered 3 concepts: (1) [internet, web, online, computer-aided, computer-assisted, computer-guided, computerized OR computerised] AND (2) [CBT, cognitive therapy, behavio(u)ral therapy OR behavio(u)r therapy] AND (3) [insomnia, sleep disorders OR sleeping problem].
- 533 potentially relevant papers were identified, and 6 randomised controlled trials (RCTs) that met the selection criteria were included in the review and analysis.
- Two RCTs were done by the same group of investigators (Ritterband and colleagues) using the same internet programmes.
- Post-treatment mean differences between groups showed that the effects of CCBT-I on sleep quality, sleep efficiency, the number of awakenings, sleep onset latency and the Insomnia Severity Index were significant, ranging from small to large effect sizes.
- However, effects on wake time after sleep onset, total sleep time and time in bed were non-significant.
- On average, the number needed to treat was 3.59.
- The treatment adherence rate for CCBT-I was high (78%).
