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Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia
Karolinska Institutet.
Karolinska Institutet.
Karolinska Institutet.
Karolinska Institutet.
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2016 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 39, no 6, p. 1267-1274, article id PII sp-00663-15Article in journal (Refereed) Published
Abstract [en]

Study Objectives: To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. Methods: This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. Results: The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P < 0.001) during the follow-up period. Conclusions: The large improvements in the ICBT-i group were maintained after 36 months, corroborating that CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period.

Place, publisher, year, edition, pages
Oxford University Press, 2016. Vol. 39, no 6, p. 1267-1274, article id PII sp-00663-15
Keyword [en]
CBT, guided self-help, insomnia, Internet, long-term follow-up, psychological treatment, psychotherapy
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
URN: urn:nbn:se:lnu:diva-73996DOI: 10.5665/sleep.5850ISI: 000378675200015PubMedID: 27091535OAI: oai:DiVA.org:lnu-73996DiVA, id: diva2:1204425
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved

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Kaldo, Viktor

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