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Digital cognitive behaviour therapy for insomnia (dCBT-I): Chronotype moderation on intervention outcomes
Patrick Faaland1,2, Øystein Vedaa1,3,4,5, Knut Langsrud2
1Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
Journal of Sleep Research
|February 28, 2022
Summary
Chronotype influences the effectiveness of digital cognitive behavioural therapy for insomnia. Morning and intermediate types showed significant improvements, while evening types experienced less benefit for psychological distress.
Area of Science:
- Sleep Medicine
- Chronobiology
- Digital Health
Background:
- Insomnia is a prevalent sleep disorder affecting millions globally.
- Digital cognitive behavioural therapy for insomnia (dCBT-I) offers a scalable treatment approach.
- Individual differences, such as chronotype, may influence treatment outcomes.
Purpose of the Study:
- To investigate if chronotype moderates the effectiveness of dCBT-I.
- To compare dCBT-I with patient education across different chronotypes.
- To assess the impact on insomnia severity, fatigue, and psychological distress.
Main Methods:
- A community-based randomized controlled trial involving 1721 participants.
- Participants were categorized into morning, intermediate, and evening chronotypes using the Horne-Östberg Morningness-Eveningness Questionnaire.
- Linear mixed modelling analyzed changes in Insomnia Severity Index, Chalder Fatigue Questionnaire, and Hospital Anxiety and Depression Scale scores post-intervention.
Main Results:
- dCBT-I was superior to patient education for morning and intermediate chronotypes across all measures.
- Evening chronotypes showed benefits from dCBT-I for insomnia severity and fatigue, but not psychological distress.
- Significant differences in treatment effects were observed between chronotypes for insomnia severity.
Conclusions:
- Self-reported chronotype is a significant moderator for dCBT-I effectiveness on insomnia severity.
- Chronotype did not significantly moderate treatment effects on psychological distress or fatigue.
- Personalizing dCBT-I based on chronotype may optimize treatment outcomes for insomnia.
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