Telemedicine vs. In-person Delivery of Cognitive Behavioral Treatment of Insomnia: a Mixed Methods Analysis

University of Pennsylvania

Status: Completed

Conditions: Insomnia Disorder

Treatments: Behavioral: CBT-I in person; Other: No intervention; Behavioral: CBT-I via Telemedicine

Study type: Interventional

Funder types: Other

Identifiers

NCT03328585

827001

Details and patient eligibility

About

Cognitive behavioral therapy for insomnia (CBT-I) has been the 'gold standard' for the treatment of insomnia. There is a need to increase access to treatment, particularly for patients in more rural locations where providers may be scarce. One solution is to utilize telemedicine which is "the use of electronic communications to provide and support health care when distance separates the provider from the patient." So the purpose of the study is to determine if receiving CBT-I by video teleconferencing works just as well as in-person treatment.

Enrollment: 62 patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Meet current DSM5 criteria for Insomnia Disorder as determined by clinician interview
• ISI score greater than 14, with self-reported duration of insomnia of at least 3 months
• Ability to read and speak English
• Own a personal computer with an internet connection sufficient to utilize the SleepTM and REDCap platform
• BMI less than 30
• Between the ages of 21-50

Exclusion criteria

• Unable or unwilling to provide informed consent
• Individuals with an untreated sleep disorder other than insomnia (Individuals with sleep apnea who are adherent with CPAP treatment (average 4 hours use per night) will be eligible to participate)
• A clinically unstable medical condition as defined by a new diagnosis or change in medical management in the previous 2 months
• Individuals with substance abuse/dependence, bipolar disorder, delirium, dementia, amnestic disorder, schizophrenia, and other psychotic disorders
• Individuals with prominent current suicidal or homicidal ideation
• Unable to perform tests due to inability to communicate verbally, inability to read and write; less than a 5th grade reading level; visual, hearing, or cognitive impairment
• Any use of medications or OTC products that might impact sleep or metabolism

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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62 participants in 3 patient groups

CBT-I in person

Active Comparator group

Treatment:

Behavioral: CBT-I in person

CBT-I via telemedicine

Experimental group

Treatment:

Behavioral: CBT-I via Telemedicine

Waitlist Control

Other group

Description:

Patients in this arm will receive in person CBT-I treatment after conclusion of the study.

Treatment:

Other: No intervention