430 Participants Needed

Digital Cognitive Behavioral Therapy for Insomnia

RJ
Overseen ByRJ Johnson, MA
Age: 18+
Sex: Any
Trial Phase: Phase 4
Sponsor: National Jewish Health
Must be taking: Hypnotics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if digital cognitive behavioral therapy (delivered through digital platforms) combined with a plan to reduce medication is more effective than reducing medication alone for people with insomnia. Many individuals with insomnia rely on sleep medications, which can pose risks over time. The trial seeks participants who have used sleep medications like benzodiazepines for over six months and wish to reduce their usage. The goal is to assess whether digital therapy can aid in reducing medication use and improving sleep. This could lead to better, more accessible treatment options for those struggling with insomnia. As a Phase 4 trial, the research focuses on understanding how this already FDA-approved and effective treatment can benefit more patients.

Will I have to stop taking my current medications?

The trial focuses on reducing or eliminating the use of hypnotic medications for insomnia, so you may need to taper off these medications as part of the study. However, the protocol does not specify if you must stop other medications, but it does exclude those using certain medications for other conditions.

What is the safety track record for these treatments?

Research has shown that Digital Cognitive Behavioral Therapy for Insomnia (dCBTI) is generally safe and easy to manage. Studies have found that dCBTI effectively reduces insomnia symptoms without causing significant side effects. For instance, a large study with 4,052 patients found that dCBTI improved sleep more effectively than medication and did not report any major negative effects.

In this trial, dCBTI is used alongside a structured plan to gradually reduce sleep medication, helping to safely decrease reliance on these drugs. Since this trial is in its later stages, sufficient evidence supports the safety of these methods.

Overall, both dCBTI and the gradual reduction of medication aim to improve sleep without the risks associated with long-term medication use, such as falls or memory problems. This makes them promising options for managing insomnia.12345

Why are researchers enthusiastic about this study treatment?

Researchers are excited about digital cognitive behavioral therapy (dCBTI) for insomnia because it offers a unique, tech-savvy approach to treatment. Unlike traditional methods that often rely on medications, dCBTI uses an online platform to help retrain the brain's sleep patterns through cognitive and behavioral techniques. This method not only aims to address the root causes of insomnia but also provides the convenience of accessing therapy from home. Additionally, when combined with structured medication tapering, it offers an innovative way to potentially reduce reliance on sleep medications, which can have side effects. Overall, this approach could transform how we manage insomnia, making effective treatment more accessible and personalized.

What evidence suggests that this trial's treatments could be effective for insomnia?

Research has shown that digital cognitive behavioral therapy for insomnia (dCBTI), which participants in this trial may receive, can greatly improve sleep. One study found that 60% of people using dCBTI experienced significant improvement in their insomnia, compared to only 16% with other treatments. Another study found that dCBTI was more effective than medication after six months, improving sleep quality and significantly reducing insomnia symptoms. These results suggest that dCBTI could be a strong option for managing insomnia, especially for those looking to reduce sleep medications. Meanwhile, another treatment arm in this trial involves structured medication tapering alone, which will be assessed for its effectiveness in managing insomnia.46789

Are You a Good Fit for This Trial?

This trial is for adults with insomnia who've been using sleep meds (benzodiazepine or non-benzodiazepine) regularly for over 6 months and want to cut down. They must meet the DSM-5 criteria for insomnia disorder and be willing to consent to participate.

Inclusion Criteria

I am willing to sign a consent form to participate.
I want to reduce or stop using sleep medications.
I have used sleep medication almost every night for more than 6 months.
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either digital cognitive behavioral therapy combined with structured medication tapering or structured medication tapering alone

22 weeks
Regular visits as per treatment protocol

Follow-up

Participants are monitored for insomnia remission and hypnotic discontinuation rates

27 weeks
Post-treatment assessments at weeks 22 and 49

What Are the Treatments Tested in This Trial?

Interventions

  • Digital Cognitive Behavioral Therapy
  • Structured Medication Tapering
Trial Overview The study tests if digital Cognitive Behavioral Therapy combined with a structured plan to gradually reduce sleep medication is more effective than reducing medication alone in primary care patients dependent on hypnotics.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Structured medication tapering aloneExperimental Treatment1 Intervention
Group II: Digital cognitive behavioral therapy combined with structured medication taperingExperimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Jewish Health

Lead Sponsor

Trials
145
Recruited
318,000+

Published Research Related to This Trial

A smartphone-based, culturally adapted digital cognitive behavioral therapy for insomnia (DCBT-I) significantly reduced insomnia severity compared to sleep education in a randomized trial with 82 participants over 6 weeks.
Participants in the DCBT-I group experienced greater improvements in total sleep time and sleep efficiency at both 3 and 6 months follow-up, indicating its efficacy in enhancing sleep quality.
Digital Cognitive Behavioral Therapy for Insomnia Using a Smartphone Application in China: A Pilot Randomized Clinical Trial.Zhang, C., Liu, Y., Guo, X., et al.[2023]
Digital cognitive behavioral therapy for chronic insomnia (D-CBT-I) is effective, with 46.4% of 414 participants achieving remission after a 6-week treatment, making it a strong first-line option for chronic insomnia.
Factors such as longer early morning awakening times and higher baseline insomnia severity negatively impacted treatment outcomes, suggesting that patients with milder insomnia and more severe depressive symptoms may benefit more from D-CBT-I.
Factors influencing the effectiveness of digital cognitive behavioural therapy for chronic insomnia in clinical practice.Shi, Y., Ren, R., Zhang, Y., et al.[2023]
Digital cognitive behavioral therapy (dCBT) significantly improves functional health, psychological well-being, and sleep-related quality of life in individuals with insomnia, based on a study of 1711 participants over 24 weeks.
The reduction in insomnia symptoms was a key factor mediating these improvements, highlighting that dCBT effectively addresses both daytime and nighttime issues related to poor sleep.
Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial.Espie, CA., Emsley, R., Kyle, SD., et al.[2023]

Citations

Digital Cognitive Behavioral Therapy vs Medication ...In this study, clinical evidence suggested that combination therapy was optimal, and dCBT-I was more effective than medication therapy, with long-term benefits ...
Comparative Effectiveness of Digital Cognitive Behavioral ...In this cohort study of 4052 patients with insomnia, dCBT-I was superior to medication therapy at 6-month follow-up, although results were found to be unstable.
A randomized controlled trial of a digital cognitive ...The findings of this study offer compelling evidence for the efficacy of tailored, digital CBT-I to treat chronic insomnia among older adults.
Efficacy of digital cognitive behavioral therapy for treating ...dCBT generated higher post-treatment insomnia remission rates (60% vs. 16%, p < 0.001). Conclusion: dCBT can effectively improve symptoms of insomnia, anxiety, ...
Effectiveness of digital cognitive-behavioral therapy for ...In both groups, there was an improvement in sleep quality, (p<0.001), sleep efficiency (p<0.001), and insomnia severity (p<0.001). The magnitude of effects on ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39110971/
Assessing the Short-Term Efficacy of Digital Cognitive ...The outcomes included measures of insomnia (the ISI and the Sleep Condition Indicator), mood disturbances, fatigue, daytime sleepiness, quality ...
Comparative efficacy of onsite, digital, and other settings ...The primary aim of the study was to compare the efficacy of available CBT-I settings on insomnia severity.
Digital Cognitive Behavioral Therapy (dCBT) for InsomniaDigital CBT for insomnia does not consistently improve symptoms of physical health conditions, for example no effect on blood pressure was seen ...
Effectiveness of group-delivered cognitive behavioural ...Results from a meta-analysis showed that group-delivered CBT-I led to improved sleep quality and better sleep, especially regarding sleep onset latency, sleep ...
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