Evaluating the Efficacy of the Management of an Online Program of Cognitive Behavioral Therapy for Primary Insomnia

Pilot Study Evaluating the Efficacy of the Management of an Online Program of Cognitive Behavioral Therapy for Primary Insomnia

The purpose of this study is to evaluate the effectiveness of the management of chronic primary insomnia patients by a computer program guidance of behavioral and cognitive therapies for insomnia (BCT-I).

Chronic insomnia is a common sleep disorder (prevalence = 10%) and a risk identified on the physical and mental health. Currently, the treatment involves the prescription of drug treatments by general practitioners, which may be unsuitable for the medium term. It is better to turn to Behavioral and Cognitive Therapies for Insomnia (BCT-I) in the case of primary chronic insomnia. The objective of this study is to evaluate the effectiveness of a computer program guidance BCT-I in patients with chronic primary insomnia. This biomedical research psychotherapeutic assessment will be randomized, controlled versus psychoeducation and conducted in 46 patients with chronic primary insomnia (defined according to Diagnostic and Statistical Manual-5) for which a supported by BCT-I is indicated.

The 46 patients will be randomized into two groups. The subjects in Group 1 will be supported by BCT-I online. And the subjects in group 2 will receive psychoeducation. All patients will be followed by the research team for three months, during which 3 visits (V0 = pre-selection; V1 = visit of randomization and start of the program; V2 = 3 months follow-up visit and end of the study) will be performed in the University Hospital Sleep Disorder Unit of Montpellier. Patients in Group 1 will conduct BCT-I online at home therapy. Patients in group 2 will receive a structured 45-minute session information insomnia (psychoeducation = work performed daily by clinicians in charge of insomnia problems) to the visit 1. All patients in the study will be equipped 2 sensors for the registration of sleep data.

The primary endpoint will be based on the severity of insomnia measured by the ISI after the last online psychotherapy session (3 months) between the 2 groups of patients (BCT-I online and without treatment - psychoeducation ). The analyse efficacity to be conducted by intention to treat.

Inclusion Criteria:

• age between 20 and 65
• disorder diagnosis of chronic insomnia (according to Diagnostic and Statistical Manual-5)
• sleep efficiency <80%
• Index severe insomnia: ISI> 14/28
• have a computer at home
• Practicing internet regularly in everyday life
• have a personal email address

Exclusion Criteria:

• Clinically suffer from insomnia comorbid linked to other sleep disorders
• Presenting an unbalanced psychiatric disorder
• Have Score Beck Depression Inventory (BDI-II) >29
• Have neurological disorders
• Have severe medical conditions that can affect the quality of sleep
• Have Hypnotic, Anxiolytic, antidepressants Treatment > 2
• Have antipsychotics, opioids, anticonvulsants, anti-parkinson treatment
• Having a disorder of substance use (alcohol, drugs) in the last 6 months
• Having undertaken a meridian trance journey (± 3H) in the preceding month or during the study period
• Already be treated with CBT-I