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| ID | Type | Description | Link |
|---|---|---|---|
| 1IK2HX001548-01A2 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| VA Office of Research and Development | FED |
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The purpose of this study is to directly compare the effectiveness of two interventions for insomnia: Brief Behavioral Treatment for Insomnia (BBTI) vs. Cognitive Behavioral Therapy for Insomnia (CBTI).
Cognitive Behavioral Therapy for Insomnia (CBTI) is the evidence-based first line treatment for chronic insomnia. Randomized controlled trials and meta-analyses have established that CBTI is efficacious and effective. Despite the strong evidence for CBTI, chronic insomnia remains under-treated among Veterans because of several barriers that limit access to behavioral treatments. In recent years, the VA has taken substantial measures to train more clinicians to provide insomnia treatment; however, a deficit in treatment availability remains. In 2011, the VA began to train clinicians in CBTI as part of the VA's Evidence Based Psychotherapy (EBP) training program, with a goal to train 1000 clinicians. Even with 1000 VA clinicians trained in CBTI, a shortage of clinicians will likely remain due to the high prevalence of insomnia. High prevalence and a shortage of clinicians prevent the VA from meeting the care demand of Veterans with insomnia. While the CBTI roll-out is a significant investment from the VA, additional mechanisms, such as dissemination and implementation of other evidence-based treatments for insomnia with fewer implementation barriers, must be considered to address the high prevalence of insomnia.
The in-person delivery and length of treatment for CBTI may be one of barriers to accessing care. Briefer protocols that use multiple delivery modalities have recently been developed and may help to increase session attendance and treatment completion. These shorter insomnia treatments are often referred to as Brief Behavioral Treatment for Insomnia (BBTI) and consist of ≤4 sessions. Besides fewer and briefer sessions, and utilizing both in-person and phone delivery of treatment, BBTI also emphasizes the behavioral components of CBTI (i.e., stimulus control and sleep restriction) rather than a combined approach focusing on both behavioral and cognitive components. BBTI is efficacious in adults-studies with older adults and Veterans found BBTI resulted in a significant decrease in insomnia severity with Cohen's d effect sizes in the moderate to large range. Like CBTI, BBTI significantly improves insomnia severity and may also help to improve secondary outcomes like depression and anxiety.
Integration of newer insomnia treatments, like BBTI, will first depend on establishing its evidence directly compared to CBTI. Effectiveness trials of BBTI, especially those conducted with military Veterans in typical VA settings, have yet to be conducted. Before BBTI can be broadly implemented and integrated into the VA, it needs to be established as a clinically effective treatment for insomnia among Veterans and a statistically non-inferior treatment (not necessarily better or worse) for Veterans compared to CBTI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CBTI | Active Comparator | CBTI consists of five in-person sessions within an eight week period. Topics covered include: sleep education, stimulus control, sleep restriction, relaxation strategies, cognitive therapy, and sleep hygiene. |
|
| BBTI | Active Comparator | BBTI consists of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered include: sleep education, stimulus control, and sleep restriction. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBTI | Behavioral | 28 Veterans with chronic insomnia will be randomized to CBTI. The intervention will be delivered in 5 face-to-face session within an 8 week time period. The intervention will be delivered at the VA Pittsburgh Healthcare System. Treatment visits will last approximately 45 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Insomnia Severity Index (ISI) | Insomnia Severity Index (ISI) 0-28; 0-7 (no symptoms), 8-14 (sub-threshold symptoms), 15-21 (moderately severe), 22-28 (severe) high scores indicate worse outcome/greater severity | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient Health Questionnaire (PHQ-9) | Patient Health Questionnaire (PHQ-9) 0-27; 0-5 (minimal), 6-10 (mild), 11-15 (moderate), 16-20 (moderate-severe), 21-27 (severe) high scores indicate worse outcome/greater severity | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Generalized Anxiety Disorder (GAD-7) |
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Inclusion Criteria:
Exclusion Criteria:
STOP-BANG is not a true acronym but indicates the symptoms each item assess:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Pittsburgh Healthcare System | Pittsburgh | Pennsylvania | 15240 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32586428 | Derived | Bramoweth AD, Lederer LG, Youk AO, Germain A, Chinman MJ. Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans. Behav Ther. 2020 Jul;51(4):535-547. doi: 10.1016/j.beth.2020.02.002. Epub 2020 Feb 20. | |
| 29373993 | Derived | Bramoweth AD, Germain A, Youk AO, Rodriguez KL, Chinman MJ. A hybrid type I trial to increase Veterans' access to insomnia care: study protocol for a randomized controlled trial. Trials. 2018 Jan 26;19(1):73. doi: 10.1186/s13063-017-2437-y. |
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92 participants met initial eligibility criteria and signed informed consent to participate in the study.
However, only 63 participants met full criteria to participate and were randomized to a treatment arm.
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| ID | Title | Description |
|---|---|---|
| FG000 | Cognitive Behavioral Therapy for Insomnia (CBTI) | Cognitive Behavioral Therapy for Insomnia (CBTI) consisted of five in-person sessions within an eight week period. Topics covered included: sleep education, stimulus control, sleep restriction, relaxation strategies, cognitive therapy, and sleep hygiene. CBTI: 32 Veterans with chronic insomnia were randomized to CBTI. The intervention was delivered in 5 face-to-face session within an 8 week time period. The intervention was delivered at the VA Pittsburgh Healthcare System. Treatment visits lasted approximately 45 minutes. |
| FG001 | Brief Behavioral Treatment for Insomnia (BBTI) | Brief Behavioral Treatment for Insomnia (BBTI) consisted of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered included: sleep education, stimulus control, and sleep restriction. BBTI: 31 Veterans with chronic insomnia were randomized to BBTI. The intervention was delivered within 5 weeks, which included individual face-to-face visits on Weeks 1 and 3 (option for telephone) and telephone appointments on Weeks 2 and 4. The intervention was delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit was approximately 45-minutes, and the follow-up visit on Week 3 was approximately 30 minutes. Brief (<20 minutes) telephone sessions were conducted on Weeks 2 and 4. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Randomized participants
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| ID | Title | Description |
|---|---|---|
| BG000 | Cognitive Behavioral Therapy for Insomnia (CBTI) | CBTI consisted of five in-person sessions within an eight week period. Topics covered included: sleep education, stimulus control, sleep restriction, relaxation strategies, cognitive therapy, and sleep hygiene. CBTI: 32 Veterans with chronic insomnia were randomized to CBTI. The intervention was delivered in 5 face-to-face session within an 8 week time period. The intervention was delivered at the VA Pittsburgh Healthcare System. Treatment visits lasted approximately 45 minutes. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Insomnia Severity Index (ISI) | Insomnia Severity Index (ISI) 0-28; 0-7 (no symptoms), 8-14 (sub-threshold symptoms), 15-21 (moderately severe), 22-28 (severe) high scores indicate worse outcome/greater severity | Participants who completed post-treatment ISI | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
baseline to 12-month follow-up (approximately 57-60 weeks)
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | CBTI | CBTI consisted of five in-person sessions within an eight week period. Topics covered included: sleep education, stimulus control, sleep restriction, relaxation strategies, cognitive therapy, and sleep hygiene. CBTI: 32 Veterans with chronic insomnia were randomized to CBTI. The intervention was delivered in 5 face-to-face session within an 8 week time period. The intervention was delivered at the VA Pittsburgh Healthcare System. Treatment visits lasted approximately 45 minutes. |
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In general, higher than expected dropout leading to smaller number of participants analyzed.
For sleep diaries, higher than expected dropout and poor completion at post-treatment resulted in small number analyzed.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Adam Bramoweth, PhD | VA Pittsburgh Healthcare System | 412-360-2806 | Adam.Bramoweth@va.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Jul 31, 2018 | May 6, 2020 | ICF_000.pdf |
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 29, 2019 | Jul 23, 2020 | Prot_SAP_001.pdf |
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| ID | Term |
|---|---|
| D007319 | Sleep Initiation and Maintenance Disorders |
| ID | Term |
|---|---|
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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|
|
| BBTI | Behavioral | 28 Veterans with chronic insomnia will be randomized to BBTI. The intervention will be delivered over 4 consecutive weeks, which include individual face-to-face visits on Weeks 1 and 3 (option for telephone), and telephone appointments on Weeks 2 and 4. Interventions will be delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit is approximately 45-minutes, and the follow-up visit on Week 3 will last no more than 30 minutes. Brief (<20 minutes) telephone sessions will be conducted on Weeks 2 and 4. |
|
|
Generalized Anxiety Disorder (GAD-7) 0-21; 0-5 (minimal), 6-10 (mild), 11-15 (moderate), 16-21 (severe) high scores indicate worse outcome/greater severity |
| post-treatment (BBTI: week 5; CBTI: week 6-9) |
| PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) | PTSD Checklist for DSM-5 (PCL-5) 0-76 (sleep item removed), higher scores indicate greater PTSD severity >33, likely PTSD diagnosis | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale | PROMIS Fatigue Scale 33.4 - 76.8 (T-score) The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a participant with a T-score of 50 is equal to the mean and a T-score of 40 is one SD below the mean. Scores less than 50 indicate less fatigue symptoms than an age and gender matched healthy population and scores greater than 50 indicate greater fatigue symptoms than an age and gender matched healthy population. | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health | PROMIS Global Health Physical Health: 16.2 - 67.7 (T-score) Mental Health: 21.2 - 67.6 (T-score) The T-score re-scales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a participant with a T-score of 50 is equal to the mean and a T-score of 40 is one SD below the mean. Scores less than 50 indicate worse quality of life than an age and gender matched healthy population and scores greater than 50 indicate better quality of life than an age and gender matched healthy population. | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Work and Social Adjustment Scale (WSAS) | Work and Social Adjustment Scale (WSAS) 0-40 higher scores indicate worse functioning | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Pittsburgh Sleep Quality Index (PSQI) | Pittsburgh Sleep Quality Index (PSQI) 0-21 higher score indicates worse sleep quality, >5 indicates poor quality sleep | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Epworth Sleepiness Scale (ESS) | Epworth Sleepiness Scale (ESS) 0-24 higher score indicates greater sleepiness, >10 indicates excessive daytime sleepiness | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Dysfunctional Beliefs and Attitudes About Sleep (DBAS) | Dysfunctional Beliefs and Attitudes About Sleep (DBAS) 0-160 reported as mean score (sum of items answered / 10 for a range 0-16) higher scores indicate greater dysfunctional beliefs and attitudes | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Patient Global Impression of Change (PGIC) | Patient Global Impression of Change (PGIC) 1-7 higher score indicative of greater subjective improvement | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Sleep Diary | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Onset Latency (SOL) - lower is better Wake After Sleep Onset (WASO) - lower is better Early Morning Awakenings (EMA) - lower is better Total Wake Time (TWT) - lower is better Total Sleep Time (TST) - higher is better Time in Bed (TIB) - value depends on TWT and TST | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Sleep Diary - Sleep Efficiency | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Efficiency (total sleep time [TST] / time in bed [TIB]) x 100 - higher is better | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| Sleep Diary - Sleep Quality | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Quality (SQ) 1-5 higher is better | post-treatment (BBTI: week 5; CBTI: week 6-9) |
| BG001 | Brief Behavioral Treatment for Insomnia (BBTI) | BBTI consisted of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered included: sleep education, stimulus control, and sleep restriction. BBTI: 31 Veterans with chronic insomnia were randomized to BBTI. The intervention was delivered within 5 weeks, which included individual face-to-face visits on Weeks 1 and 3 (option for telephone) and telephone appointments on Weeks 2 and 4. The intervention was delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit was approximately 45-minutes, and the follow-up visit on Week 3 was approximately 30 minutes. Brief (<20 minutes) telephone sessions were conducted on Weeks 2 and 4. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Insomnia Severity Index (ISI) | Insomnia Severity Index (ISI) 0-28; 0-7 (no symptoms), 8-14 (sub-threshold symptoms), 15-21 (moderately severe), 22-28 (severe) high scores indicate worse outcome/greater severity | Mean | Standard Deviation | score on a scale |
|
| Pittsburgh Sleep Quality Index (PSQI) | Pittsburgh Sleep Quality Index (PSQI) 0-21 higher score indicates worse sleep quality, >5 indicates poor quality sleep | Mean | Standard Deviation | score on a scale |
|
| Patient Global Impression of Change (PGIC) | Patient Global Impression of Change (PGIC) 1-7 higher score indicative of greater subjective improvement | Mean | Standard Deviation | score on a scale |
|
| OG001 | BBTI | BBTI consisted of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered included: sleep education, stimulus control, and sleep restriction. BBTI: 31 Veterans with chronic insomnia were randomized to BBTI. The intervention was delivered within 5 weeks, which included individual face-to-face visits on Weeks 1 and 3 (option for telephone) and telephone appointments on Weeks 2 and 4. The intervention was delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit was approximately 45-minutes, and the follow-up visit on Week 3 was approximately 30 minutes. Brief (<20 minutes) telephone sessions were conducted on Weeks 2 and 4. |
|
|
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| Secondary | Patient Health Questionnaire (PHQ-9) | Patient Health Questionnaire (PHQ-9) 0-27; 0-5 (minimal), 6-10 (mild), 11-15 (moderate), 16-20 (moderate-severe), 21-27 (severe) high scores indicate worse outcome/greater severity | Participants who completed post-treatment PHQ-9 (no sleep item) | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Generalized Anxiety Disorder (GAD-7) | Generalized Anxiety Disorder (GAD-7) 0-21; 0-5 (minimal), 6-10 (mild), 11-15 (moderate), 16-21 (severe) high scores indicate worse outcome/greater severity | Participants who completed post-treatment GAD-7 | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) | PTSD Checklist for DSM-5 (PCL-5) 0-76 (sleep item removed), higher scores indicate greater PTSD severity >33, likely PTSD diagnosis | Participants who completed post-treatment PCL-5 | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale | PROMIS Fatigue Scale 33.4 - 76.8 (T-score) The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a participant with a T-score of 50 is equal to the mean and a T-score of 40 is one SD below the mean. Scores less than 50 indicate less fatigue symptoms than an age and gender matched healthy population and scores greater than 50 indicate greater fatigue symptoms than an age and gender matched healthy population. | Participants who completed post-treatment PROMIS Fatigue | Posted | Mean | Standard Deviation | T-score | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health | PROMIS Global Health Physical Health: 16.2 - 67.7 (T-score) Mental Health: 21.2 - 67.6 (T-score) The T-score re-scales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a participant with a T-score of 50 is equal to the mean and a T-score of 40 is one SD below the mean. Scores less than 50 indicate worse quality of life than an age and gender matched healthy population and scores greater than 50 indicate better quality of life than an age and gender matched healthy population. | Participants who completed post-treatment PROMIS Global Health | Posted | Mean | Standard Deviation | T-score | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
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| Secondary | Work and Social Adjustment Scale (WSAS) | Work and Social Adjustment Scale (WSAS) 0-40 higher scores indicate worse functioning | Participants who completed post-treatment WSAS | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Pittsburgh Sleep Quality Index (PSQI) | Pittsburgh Sleep Quality Index (PSQI) 0-21 higher score indicates worse sleep quality, >5 indicates poor quality sleep | Participants that completed post-treatment PSQI assessment | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
|
| Secondary | Epworth Sleepiness Scale (ESS) | Epworth Sleepiness Scale (ESS) 0-24 higher score indicates greater sleepiness, >10 indicates excessive daytime sleepiness | Participants who completed post-treatment ESS | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Dysfunctional Beliefs and Attitudes About Sleep (DBAS) | Dysfunctional Beliefs and Attitudes About Sleep (DBAS) 0-160 reported as mean score (sum of items answered / 10 for a range 0-16) higher scores indicate greater dysfunctional beliefs and attitudes | Participants who completed post-treatment DBAS | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
|
|
| Secondary | Patient Global Impression of Change (PGIC) | Patient Global Impression of Change (PGIC) 1-7 higher score indicative of greater subjective improvement | Participants that completed post-treatment PGIC | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
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| Secondary | Sleep Diary | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Onset Latency (SOL) - lower is better Wake After Sleep Onset (WASO) - lower is better Early Morning Awakenings (EMA) - lower is better Total Wake Time (TWT) - lower is better Total Sleep Time (TST) - higher is better Time in Bed (TIB) - value depends on TWT and TST | Participants who completed post-treatment Sleep Diaries | Posted | Mean | Standard Deviation | minutes | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
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| Secondary | Sleep Diary - Sleep Efficiency | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Efficiency (total sleep time [TST] / time in bed [TIB]) x 100 - higher is better | Participants who completed post-treatment Sleep Diaries | Posted | Mean | Standard Deviation | percentage of TST / TIB | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
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| Secondary | Sleep Diary - Sleep Quality | The Sleep Diary measures common sleep variables important for tracking and changing sleep behaviors Sleep Quality (SQ) 1-5 higher is better | Participants who completed post-treatment Sleep Diaries | Posted | Mean | Standard Deviation | score on a scale | post-treatment (BBTI: week 5; CBTI: week 6-9) |
|
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|
| 0 |
| 32 |
| 0 |
| 32 |
| 0 |
| 32 |
| EG001 | BBTI | BBTI consisted of one in-person session with three weekly follow-up sessions (in-person or phone) in a four week period. Topics covered included: sleep education, stimulus control, and sleep restriction. BBTI: 31 Veterans with chronic insomnia were randomized to BBTI. The intervention was delivered within 5 weeks, which included individual face-to-face visits on Weeks 1 and 3 (option for telephone) and telephone appointments on Weeks 2 and 4. The intervention was delivered at the VA Pittsburgh Healthcare System. The duration of the first treatment visit was approximately 45-minutes, and the follow-up visit on Week 3 was approximately 30 minutes. Brief (<20 minutes) telephone sessions were conducted on Weeks 2 and 4. | 0 | 31 | 0 | 31 | 0 | 31 |
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| D001523 |
| Mental Disorders |
| Early Morning Awakenings (EMA) |
|
| Total Wake Time (TWT) |
|
| Total Sleep Time (TST) |
|
| Time in Bed (TIB) |
|