Digital cognitive behavioral therapy improves insomnia symptoms in stroke survivors

1. In this randomized controlled trial, patients who received digital cognitive behavioral therapy (dCBT) demonstrated improvements in insomnia symptoms compared to the control group.

2. Although there were also improvements in sleep-onset latency and mood in those who received dCBT, there was no significant improvement in quality of life.

Evidence Rating Level: 1 (Excellent)

Stroke survivors tend to suffer from long-term sleep disruption, negatively impacting their quality of life. Cognitive behavioral therapy (CBT) is often prescribed for the treatment of insomnia, but its role in improving sleep disruption in stroke patients has not been well established. As a result, the objective of the present study was to evaluate the effectiveness of a digital CBT (dCBT) program in improving the sleep of stroke patients.

This randomized controlled trial enlisted 84 participants in the UK between February 2020 and June 2021. Participants were included if they were older than 18 years of age, >3 months post-stroke, and had a desire to improve their sleep. Participants were excluded if they had a serious condition that would affect their participation, had an upcoming surgery scheduled within 5 months, were receiving psychological treatment for insomnia, were pregnant, had seizures, had untreated obstructive sleep apnea, or engaged in shiftwork. Participants were randomized to either the dCBT intervention or a control group that received information on sleep hygiene. The intervention group completed six weekly dCBT sessions. Insomnia symptoms were determined using the Sleep Condition Indicator-8 (SCI-8). Insomnia symptoms and information on sleep-onset latency, mood, and quality of life were assessed at baseline, at the end of the intervention, and again 8 weeks later. The primary outcome was self-reported insomnia symptoms.

The results demonstrated that patients in the dCBT group experienced significant improvements in insomnia symptoms compared to the control group, as evidenced by improved SCI-8 scores. Furthermore, the dCBT group demonstrated improvements in sleep-onset latency and mood compared to the control group, but there were no differences in other factors, such as quality of life. Despite this, the results were limited by the self-reported nature of stroke symptoms, which limited the ability to investigate differences in stroke characteristics between the treatment and control groups. Nonetheless, the study identified dCBT as a possible therapy for improving insomnia symptoms in stroke survivors.

Click to read the study in Journal of Sleep Research

Image: PD

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