In the Journals

Digital CBT program mitigates insomnia symptoms in pregnant women

Jennifer N. Felder

Digital cognitive behavioral therapy was effective, scalable, safe and acceptable for improving insomnia symptoms among pregnant women, according to results of a randomized clinical trial published in JAMA Psychiatry.

“Although sleep disturbance is a common symptom of pregnancy, a subset of pregnant women experiences more severe sleep disturbances, called insomnia,” Jennifer N. Felder, PhD, of the department of psychiatry at University of California, San Francisco, told Healio Psychiatry. “Prenatal insomnia is associated with adverse outcomes, like depression and preterm birth. Until recently, it was unknown whether we could improve insomnia during pregnancy, but our findings show that a digital CBT for insomnia (CBT-I) program is effective and safe for treating insomnia symptoms during pregnancy. This is an important treatment option for pregnant women, who prefer nonpharmacological treatments for insomnia.”

To test digital CBT-I’s efficacy compared with standard treatment among this patient population, Felder and colleagues randomly assigned 105 participants to receive digital CBT-I and 103 to receive standard treatment. The digital CBT-I intervention consisted of six weekly sessions of approximately 20 minutes each delivered through the Sleepio (Big Health) program. Participants were pregnant up to 28 weeks’ gestation and either met the criteria for insomnia or had elevated insomnia symptom severity as determined by self-report questionnaires. At 10 weeks and 18 weeks after being randomly assigned, participants completed outcome measures.

Felder and colleagues found that among the 208 participants, those who received digital CBT-I had statistically significantly greater improvements in insomnia symptom severity from baseline to 10 weeks compared with those assigned to receive standard treatment. These improvements were statistically significant for all secondary outcomes, with the exception of sleep duration. The researchers also found a similar patterns of results for the change from baseline to 18 weeks.

“We were pleased to see that digital CBT-I had additional benefits for depression and anxiety symptoms, including 16% of women who received Sleepio having experienced elevated depression symptoms after finishing the intervention compared with 31% of women who received treatment as usual, as well as 2% of women who received Sleepio having experienced moderate-to-severe anxiety symptoms compared with 8% of women who received treatment as usual,” Felder said. – by Joe Gramigna

Disclosures: Felder reports receiving voucher codes for Sleepio from Big Health, as well as a grant from the NIH. Please see the study for all other authors’ relevant financial disclosures.

Jennifer N. Felder

Digital cognitive behavioral therapy was effective, scalable, safe and acceptable for improving insomnia symptoms among pregnant women, according to results of a randomized clinical trial published in JAMA Psychiatry.

“Although sleep disturbance is a common symptom of pregnancy, a subset of pregnant women experiences more severe sleep disturbances, called insomnia,” Jennifer N. Felder, PhD, of the department of psychiatry at University of California, San Francisco, told Healio Psychiatry. “Prenatal insomnia is associated with adverse outcomes, like depression and preterm birth. Until recently, it was unknown whether we could improve insomnia during pregnancy, but our findings show that a digital CBT for insomnia (CBT-I) program is effective and safe for treating insomnia symptoms during pregnancy. This is an important treatment option for pregnant women, who prefer nonpharmacological treatments for insomnia.”

To test digital CBT-I’s efficacy compared with standard treatment among this patient population, Felder and colleagues randomly assigned 105 participants to receive digital CBT-I and 103 to receive standard treatment. The digital CBT-I intervention consisted of six weekly sessions of approximately 20 minutes each delivered through the Sleepio (Big Health) program. Participants were pregnant up to 28 weeks’ gestation and either met the criteria for insomnia or had elevated insomnia symptom severity as determined by self-report questionnaires. At 10 weeks and 18 weeks after being randomly assigned, participants completed outcome measures.

Felder and colleagues found that among the 208 participants, those who received digital CBT-I had statistically significantly greater improvements in insomnia symptom severity from baseline to 10 weeks compared with those assigned to receive standard treatment. These improvements were statistically significant for all secondary outcomes, with the exception of sleep duration. The researchers also found a similar patterns of results for the change from baseline to 18 weeks.

“We were pleased to see that digital CBT-I had additional benefits for depression and anxiety symptoms, including 16% of women who received Sleepio having experienced elevated depression symptoms after finishing the intervention compared with 31% of women who received treatment as usual, as well as 2% of women who received Sleepio having experienced moderate-to-severe anxiety symptoms compared with 8% of women who received treatment as usual,” Felder said. – by Joe Gramigna

Disclosures: Felder reports receiving voucher codes for Sleepio from Big Health, as well as a grant from the NIH. Please see the study for all other authors’ relevant financial disclosures.