Computerised Cognitive Behavioural Therapy for Insomnia: A Systematic Review and Meta-Analysis
Psychotherapy and Psychosomatics, 05/16/2012
Evidence Based Medicine
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%).