Cognitive Behavioral Therapy Delivered by Telemedicine is Effective for Insomnia

Preliminary findings from two analyses of an ongoing study suggest that cognitive behavioral therapy for insomnia delivered by telemedicine is as effective as face-to-face delivery. Results of a randomized controlled non-inferiority trial show that both delivery methods were equally effective at improving sleep outcomes measured by sleep diaries, reducing self-reported sleep latency and wake after sleep onset while increasing total sleep time and sleep efficiency. There also were no differences between the two delivery methods in patient perception of therapeutic alliance, warmth, and confidence in the therapist's skills.

"The most surprising findings in the study were that, contrary to our hypotheses, participants who received CBT for insomnia via telemedicine rated therapist alliance similarly to participants who received face-to-face CBT for insomnia," said principal investigator J. Todd Arnedt, Ph.D., an associate professor of psychiatry and neurology and co-director of the Sleep and Circadian Research Laboratory at Michigan Medicine, University of Michigan in Ann Arbor. "In addition, ratings of satisfaction with treatment were equivalent between face-to-face and telemedicine participants. Relative to other remote modalities, telemedicine may offer a unique blend of convenience for the patient while preserving fidelity of the face-to-face interaction."

Insomnia involves difficulty falling asleep or staying asleep, or regularly waking up earlier than desired, despite allowing enough time in bed for sleep. Daytime symptoms associated with insomnia include fatigue or sleepiness; feeling dissatisfied with sleep; having trouble concentrating; feeling depressed, anxious or irritable; and having low motivation or energy.

The most effective treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I). It combines behavioral strategies, such as setting a consistent sleep schedule and getting out of bed when struggling with sleep, with cognitive strategies, such as replacing fears about sleeplessness with more helpful expectations. CBT-I recommendations are customized to address each patient's individual needs and symptoms.

The analysis comparing sleep and daytime functioning variables included 47 adults with chronic insomnia, including 33 women. The analysis of therapeutic alliance involved 38 adults with insomnia, including 25 women. Participants had a mean age of about 52 years. They were randomized to six sessions of CBT-I delivered face-to-face or via the AASM SleepTM telemedicine system. One therapist delivered CBT-I in both conditions.

"Preliminary findings from this study suggest that patients undergoing telemedicine for insomnia can feel just as close and supported by their therapist as if they were in the office," said co-investigator Deirdre Conroy, Ph.D., a clinical associate professor of psychiatry and clinical director of the Behavioral Sleep Medicine Program at Michigan Medicine, University of Michigan in Ann Arbor. "Telemedicine could be utilized more for CBT-I to bridge the gap between supply and demand for this service."

Both research abstracts were published recently in an online supplement of the journal Sleep and will be presented Monday, June 10, in San Antonio at SLEEP 2019, the 33rd annual meeting of the Associated Professional Sleep Societies LLC (APSS), which is a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

The study was supported by funding from the American Academy of Sleep Medicine Foundation.

Deirdre A Conroy, Ann Mooney, Dari Pace, Sydney Balstad, Kelley Dubuc, Alexander Yang, J Todd Arnedt.
0364 Comparison of Therapeutic Alliance for Telemedicine vs. Face-to-Face Delivered Cognitive Behavioral Therapy for Insomnia: Preliminary Results.
Sleep, Volume 42, April 2019, Pages A148-A149. doi: 10.1093/sleep/zsz067.363.

Most Popular Now

Philips Foundation 2024 Annual Report: E…

Marking its tenth anniversary, Philips Foundation released its 2024 Annual Report, highlighting a year in which the Philips Foundation helped provide access to quality healthcare for 46.5 million people around...

New AI Transforms Radiology with Speed, …

A first-of-its-kind generative AI system, developed in-house at Northwestern Medicine, is revolutionizing radiology - boosting productivity, identifying life-threatening conditions in milliseconds and offering a breakthrough solution to the global radiologist...

Scientists Argue for More FDA Oversight …

An agile, transparent, and ethics-driven oversight system is needed for the U.S. Food and Drug Administration (FDA) to balance innovation with patient safety when it comes to artificial intelligence-driven medical...

Giving Doctors an AI-Powered Head Start …

Detection of melanoma and a range of other skin diseases will be faster and more accurate with a new artificial intelligence (AI) powered tool that analyses multiple imaging types simultaneously...

New Research Finds Specific Learning Str…

If data used to train artificial intelligence models for medical applications, such as hospitals across the Greater Toronto Area, differs from the real-world data, it could lead to patient harm...

AI Agents for Oncology

Clinical decision-making in oncology is challenging and requires the analysis of various data types - from medical imaging and genetic information to patient records and treatment guidelines. To effectively support...

'AI Scientist' Suggests Combin…

An 'AI scientist', working in collaboration with human scientists, has found that combinations of cheap and safe drugs - used to treat conditions such as high cholesterol and alcohol dependence...

Start-ups in the Spotlight at MEDICA 202…

17 - 20 November 2025, Düsseldorf, Germany. MEDICA, the leading international trade fair and platform for healthcare innovations, will once again confirm its position as the world's number one hotspot for...