0979 Internet-Based Cognitive Behavioral Therapy for Insomnia in Appalachian Women: A Pilot Study. (12th April 2019)

• Record Type: Journal Article
• Authors: Moloney, Mairead E; Martinez, Ashley I; Badour, Christal L; Moga, Daniela C
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A394
• Page End: A394
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.976
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Appalachian women live in an insomnia "hotspot, " and have limited access to health services. The most prevalent insomnia treatments, prescription and non-prescription sleep aids, are associated with negative side effects including falls and confusion. Conversely, cognitive behavioral therapy for insomnia (CBT-I) is proven safe and effective for insomnia and may also reduce stress, sleep aid use, and depression symptoms. The purpose of this study was to pilot test Sleep Healthy Using the Internet (SHUTi), a well-validated Internet-based version of CBT-I among Appalachian women ages 45+, and to gather preliminary efficacy data on changes in insomnia severity, perceived stress, depression symptoms, and sleep aid use. Methods: We employed a single group, pretest-posttest design. Pre- and post-intervention, participants completed an online survey and a semi-structured, qualitative interview. Quantitative data were analyzed using one-way repeated measures ANOVA or generalized estimating equations where appropriate. Interview data were qualitatively analyzed using a multi-stage coding process. Results: Forty-six women enrolled; 38 completed the Internet-based program (retention rate = 82.6%). Mean participant age was 55.1. Positive and statistically significant (p<0.01) improvements were observed on mean score measures for the Insomnia Severity Index (15.1 to 6.5), the Perceived Stress Scale (20 to 14.6), and the Center for Epidemiologic Studies Depression Scale Revised (10: 9.8 to 5.2). The odds of reporting sleep aid use post-intervention were lower than pre-intervention (OR 0.28 [95% CI 0.11-0.74; p=0.01]). Qualitative interviews revealed that insomnia onset was often preceded by an acute social stressor (e.g., death of a child) and perpetuated by a chronic social stressor (e.g., raising a grandchild). Conclusion: These pilot findings suggest that Internet-based CBT-I may be a useful, non-pharmacologic treatment that reduces insomnia severity, perceived stress, depression symptoms, and sleep aid use in the health disparities population of Appalachian women. Support (If Any): This project was supported by the Building Interdisciplinary Research Careers in Women's Health Program (NIDA grant: K12DA035150), pilot funding from the Igniting Research Collaborations Grant (University of Kentucky College of Pharmacy) and the University of Kentucky Center for Clinical and Translational Sciences (grant: UL1TROO1998).