Document Type
Journal Article
Publication Title
Psychogeriatrics
Publisher
Wiley
School
Office of Deputy Vice-Chancellor (Students, Equity and Indigenous) / School of Medical and Health Sciences / School of Nursing and Midwifery
RAS ID
64563
Funders
Australian Government Research Training Program Scholarship
Abstract
Background
To examine treatment mechanisms of digitally delivered cognitive behavioural therapy for insomnia (CBT-I), this study assessed the mediating effects of dysfunctional beliefs, hyperarousal, locus of control, self-efficacy, sleep effort, and safety behaviours on self-reported insomnia severity in older adults before and following the completion of a self-guided, online CBT-I program.
Methods
The baseline and follow-up measurements were completed by 62 older adults (55 female, 89%). This was a two-condition within-participant design. Mediation analysis using a parallel mediation model was conducted using the MEMORE macro for repeated measure designs.
Results
Out of all the included mediator variables, only a reduction in sleep effort scores (0.88; SE 0.51; 95% CI 0.001–2.00) significantly mediated changes in insomnia severity scores following the intervention. Insomnia severity scores significantly reduced following the intervention (Mpre = 9.84, SD = 5.89, Mpost = 6.87, SD = 4.90); t(61) = 5.19, P = < 0.001; d = 0.55 95% CI 0.38–0.93.
Conclusions
Sleep in older adults improved following digitally delivered CBT-I, and these changes were influenced by a reduction in sleep control efforts exerted by participants. These findings highlight possible treatment pathways of CBT-I. Further investigation of CBT-I as a strategy to prevent sleep problems is warranted.
DOI
10.1111/psyg.13074
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Comments
Kutzer, Y., Whitehead, L., Quigley, E., & Stanley, M. (2024). Changes in sleep effort mediate insomnia severity in older adults following online cognitive behavioural therapy. Psychogeriatrics. Advance online publication. https://doi.org/10.1111/psyg.13074