Digital Cognitive Behavioural Therapy for Insomnia Delivered Within a Crenotherapy Setting: Results from a...

Area of Science:

• Sleep Medicine
• Digital Health
• Behavioral Therapy

Background:

• Insomnia disorder is common and debilitating, with limited access to effective treatments like cognitive behavioural therapy for insomnia (CBT-I).
• Digital CBT-I (dCBT-I) offers a scalable solution, but outcomes vary based on delivery context.
• Crenotherapy, a medically supervised thermal spa treatment, is explored as a potential context for dCBT-I delivery.

Purpose of the Study:

• To evaluate if delivering dCBT-I within a structured, medically supervised crenotherapy program enhances insomnia symptom improvement compared to stand-alone dCBT-I.
• To assess the impact on subjective sleep, functioning, arousal, and psychological symptoms.
• To evaluate participant engagement and satisfaction with both intervention formats.

Main Methods:

• A multicentre, proof-of-concept randomized controlled trial involving 66 adults diagnosed with insomnia disorder.
• Participants were assigned to either stand-alone dCBT-I (n=38) or dCBT-I integrated into a 3-week crenotherapy program (n=28).
• Primary outcome: change in Insomnia Severity Index (ISI) scores; secondary outcomes: sleep parameters, functioning, arousal, anxiety, and depression.

Main Results:

• Both groups demonstrated significant improvements in insomnia severity and psychological symptoms.
• No statistically significant difference in ISI scores was found between the crenotherapy-delivered and stand-alone dCBT-I groups.
• Exploratory subgroup analyses indicated greater ISI improvements in younger participants (<60) and those with baseline anxiety in the crenotherapy group.

Conclusions:

• Delivering dCBT-I within a crenotherapy context is feasible and may provide specific benefits for younger individuals and those with comorbid anxiety.
• These findings suggest that context-sensitive digital health models can improve personalized insomnia treatment.
• Further research is warranted to explore the potential of integrated digital and traditional therapeutic settings for insomnia management.