Efficacy of Internet‐based cognitive behavioral therapy on sleeping difficulties in menopausal women: A randomized controlled trial

Abstract

Sleeping difficulties are the most significant cause of disability in menopausal women. Cognitive behavioral therapy (CBT) is the first line of management for sleeping difficulties and chronic insomnia. Purpose To evaluate the efficacy of an Internet‐based CBT program on sleeping difficulties in menopausal women. Design This was a randomized controlled trial. A total of 80 eligible menopausal women who fit the criteria of poor sleep quality were randomly and evenly assigned to the CBT intervention group or the control group. Tools The tools used for data collection were the demographic sheet, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and sleep diary. Internet‐based CBT modules were administered to the intervention group. Six consecutive modules were held weekly for each participant. Sleep quality scores and insomnia index scores were considered the primary outcomes, while sleep diaries were the secondary outcomes. Self‐administered questionnaires were given at baseline and 6 weeks after randomization. Findings Internet‐based CBT is effective in reducing sleeping difficulties, particularly sleep quality scores (−3.60 ± 2.76) and insomnia index scores (−5.10 ± 3.54) from baseline. Moreover, the program induced significant changes in sleep parameters, such as increased total sleep hours (t = 2.734, p = 0.008), increased sleep efficiency ≥85%, (t = 3.558, p = 0.001), and decreased sleep latency (t = 2.180, p = 0.033) compared with the control group. Conclusion: The strong predictors of having very poor sleep quality were short duration since last menopause, severity of hot flashes, and short duration of sleep difficulties. Practice Implication Internet‐based CBT is a useful practical intervention for managing sleeping difficulties in menopausal women. The current study provides evidence on the efficacy and cost‐effectiveness of Internet‐based cognitive behavioral intervention; thus, we recommend this method as a practical and accessible intervention to improve sleep in menopausal women.

Brain Activity in Different Brain Areas of Patients With Dry Eye During the Female Climacteric Period According to Voxel-Based Morphometry

“…In another study, DE patients showed sleep quality reduction ( 26 ). In addition, menopausal women with sexual dysfunction also reported a higher prevalence of depression and anxiety ( 27 ), as well as sleeping disorders ( 28 ). In the present study, the VBM values of Thalamus_R were obviously decreased in DE patients compared to HCs, which corresponded with emotional changes (depression and anxiety) and sleep disorders in DE patients during menopause.…”

Does a program‐based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

“…The intervention group experienced seven weekly 50–60‐min face‐to‐face group CBT sessions. The CBT program was developed by the research team after reviewing the literature and consulting with experts (Abdelaziz et al., 2022; El‐Monshed et al., 2022; Hassan et al., 2021; John et al., 2022; Kalmbach, Cheng, Arnedt, et al., 2019; Kalmbach, Cheng, Todd Arnedt, et al., 2019; Khoshbooii et al., 2021). The principal investigator and last author are trained counselors in CBT and provided all sessions to the study participants.…”

“…Utilizing the G-power software program V.3.1.9.7 (Faul et al, 2007), the required sample size was calculated. A predicted effect size of r = .48 was used based on findings from Abdelaziz et al (2022), who investigated the impact of CBT on a similar population of menopausal women. Using a 95% confidence interval (CI), 0.80 statistical power, and fair division of participants between treatment and control groups, the needed sample size was determined to be 38 women per group.…”

“…According to prior research, CBT helps women adopt new mindsets and behaviors that help improve their sleep (Abdelaziz et al., 2022; Hunter, 2020). A previous study found encouraging preliminary findings in a pilot trial evaluating four CBT sessions for insomnia to standard care for individuals whose depression did not entirely resolve with psychopharmacology and who still had residual symptoms of insomnia.…”