Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms

Zweerde, Tanja van der; Straten, Annemieke van; Effting, Marieke; Kyle, Simon D.; Lancee, Jaap

doi:10.1017/s0033291718001149

Cited by 77 publications

(61 citation statements)

References 64 publications

(93 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large RCT in insomnia patients found that internet-based CBT-I ameliorated subclinical depression symptoms [28]. Other studies have shown similar results confirming that CBT-I is effective in reducing both insomnia and depressive symptoms [29,30] and can even prevent a depressive episode at 1 year follow up [31]. Interestingly, a study comparing CBT for insomnia and CBT for depression in comorbid insomnia and depression patients, found that CBT for insomnia was equally effective in reducing depression severity compared with CBT for depression, while more effective in reducing insomnia complaints [32,33].…”

mentioning

confidence: 86%

Internet-guided cognitive, behavioral and chronobiological interventions in depression-prone insomnia subtypes: protocol of a randomized controlled prevention trial

et al. 2020

View full text Add to dashboard Cite

Background: Major depressive disorder is among the most burdening and costly chronic health hazards. Since its prognosis is poor and treatment effectiveness is moderate at best, prevention would be the strategy of first choice. Insomnia may be the best modifiable risk factor. Insomnia is highly prevalent (4-10%) and meta-analysis estimates ±13% of people with insomnia to develop depression within a year. Among people with insomnia, recent work identified three subtypes with a particularly high lifetime risk of depression. The current randomized controlled trial (RCT) evaluates the effects of internet-guided Cognitive Behavioral Therapy for Insomnia (CBT-I), Chronobiological Therapy (CT), and their combination on insomnia and the development of depressive symptoms. Methods:We aim to include 120 participants with Insomnia Disorder (ID) of one of the three subtypes that are more prone to develop depression. In a two by two factorial repeated measures design, participants will be randomized to CBT-I, CT, CBT-I + CT or treatment as usual, and followed up for one year. The primary outcome is the change, relative to baseline, of the severity of depressive symptoms integrated over four follow-ups spanning one year. Secondary outcome measures include a diagnosis of major depressive disorder, insomnia severity, sleep diaries, actigraphy, cost-effectiveness, and brain structure and function.(Continued on next page)

show abstract

mentioning

confidence: 86%

Internet-guided cognitive, behavioral and chronobiological interventions in depression-prone insomnia subtypes: protocol of a randomized controlled prevention trial

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Insomnia is a primary risk factor for the development of depression [2]. In people with depression, insomnia impedes remission [3, 4], while cognitive-behavioral therapy for insomnia (CBTI) accelerates it [5, 6]. However, overlap in the symptoms of insomnia and depression obscures the sequential development and order of treatment-induced changes: do CBTI-induced sleep improvements precede alleviation of depression symptoms, or does CBTI affect depression directly?…”

mentioning

confidence: 99%

“…We used data from a randomized controlled trial [6] in which participants with symptoms of insomnia and depression received either 5 weeks of CBTI ( n = 52) or no treatment ( n = 52). Symptoms of insomnia (Insomnia Severity Index) and depression (Patient Health Questionnaire) were assessed at the end of each week, for 10 weeks (before treatment T0–T1, during treatment T2–T6, after treatment T7–T9).…”

mentioning

confidence: 99%

Introducing Network Intervention Analysis to Investigate Sequential, Symptom-Specific Treatment Effects: A Demonstration in Co-Occurring Insomnia and Depression

Blanken

Zweerde

Straten

et al. 2019

Psychother Psychosom

114

107

View full text Add to dashboard Cite

“…Surprisingly, on many of these indices no effect of I-CBT-I was observed, a finding only partly in line with other trials. For instance, CBT-I often also has beneficial effects for depression and anxiety complaints [48][49][50]. We were able to replicate the effect at the posttest assessment for depressive complaints but this was no longer detected at the 26-week follow-up.…”

Section: Discussionmentioning

confidence: 72%

Nurse-Guided Internet-Delivered Cognitive Behavioral Therapy for Insomnia in General Practice: Results from a Pragmatic Randomized Clinical Trial

Zweerde

Lancee

Slottje

et al. 2020

Psychother Psychosom

View full text Add to dashboard Cite

Introduction: Guidelines recommend cognitive behavioral therapy for insomnia (CBT-I) as the first line of treatment for insomnia in general practice, but CBT-I is rarely available. Nurse-guided Internet-delivered CBT-I might be a solution to improve access to care. Objective: We aimed to determine the effectiveness of nurse-guided Internet-delivered CBT-I (I-CBT-I) on insomnia severity experienced by patients in general practice. Methods: Nurse-guided I-CBT-I (“i-Sleep”) was compared to care-as-usual (and I-CBT-I after 6 months) in 15 participating general practices among 134 patients (≥18 years old) with clinical insomnia symptoms. Assessments took place at 8, 26 and 52 weeks. Primary outcome was self-reported insomnia severity (Insomnia Severity Index) at 8 weeks. Secondary outcomes were sleep diary indices, depression and anxiety symptoms (Hospital Anxiety and Depression Scale), fatigue, daytime consequences of insomnia, sleep medication and adverse events. Results: Two thirds of the 69 intervention patients (n = 47; 68%) completed the whole intervention. At the posttest examination, there were large significant effects for insomnia severity (Cohen’s d =1.66), several sleep diary variables (wake after sleep onset, number of awakenings, terminal wakefulness, sleep efficiency, sleep quality) and depression. At 26 weeks there were still significant effects on insomnia severity (d = 1.02) and on total sleep time and sleep efficiency. No significant effects were observed for anxiety, fatigue, daily functioning or sleep medication. No adverse events were reported. Conclusions: Nurse-guided I-CBT-I effectively reduces insomnia severity among general practice patients. I-CBT-I enables general practitioners to offer effective insomnia care in accordance with the clinical guidelines.

show abstract

Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms

Abstract: NTR6049 (Netherlands Trial Register).

Cited by 77 publications

References 64 publications

Internet-guided cognitive, behavioral and chronobiological interventions in depression-prone insomnia subtypes: protocol of a randomized controlled prevention trial

Internet-guided cognitive, behavioral and chronobiological interventions in depression-prone insomnia subtypes: protocol of a randomized controlled prevention trial

Introducing Network Intervention Analysis to Investigate Sequential, Symptom-Specific Treatment Effects: A Demonstration in Co-Occurring Insomnia and Depression

Nurse-Guided Internet-Delivered Cognitive Behavioral Therapy for Insomnia in General Practice: Results from a Pragmatic Randomized Clinical Trial

Contact Info

Product

Resources

About