Testing an app-based intervention to improve insomnia in patients with epilepsy: A randomized controlled trial

Area of Science:

• Neurology
• Sleep Medicine
• Digital Health

Background:

• Insomnia significantly impacts individuals with epilepsy, affecting their overall health and well-being.
• Existing treatments for insomnia in epilepsy patients may have limitations, necessitating novel approaches.

Purpose of the Study:

• To evaluate the efficacy of a novel app-based cognitive behavioral therapy for insomnia (CBT-I) in improving insomnia symptoms and psychological factors in people with epilepsy.
• To explore the underlying mechanisms through which the CBT-I intervention influences sleep outcomes in this population.

Main Methods:

• A randomized controlled trial involving 320 individuals with epilepsy and moderate to severe insomnia was conducted.
• Participants were assigned to either an app-based CBT-I group or a patient education control group.
• Primary outcomes included sleep quality, insomnia severity, sleep hygiene, and actigraphy-measured sleep characteristics, assessed over six months. Secondary outcomes encompassed psychological factors and quality of life.

Main Results:

• The CBT-I group demonstrated significant improvements in sleep quality, insomnia severity, sleep hygiene, and sleep onset latency compared to the control group.
• Individuals in the CBT-I group also experienced significant reductions in anxiety and depression, alongside improvements in quality of life.
• Mediation analyses indicated that psychological factors such as attitude, intention, coping planning, self-monitoring, and behavioral automaticity played a crucial role in the intervention's effect on sleep outcomes.

Conclusions:

• The findings support the use of an app-based CBT-I intervention as an effective tool for enhancing sleep outcomes in individuals with epilepsy.
• This digital health approach offers a promising avenue for managing insomnia in this vulnerable patient population.