Enhancing sleep and mood in depressed adolescents: A randomized trial on nurse-led digital cognitive behavioral therapy for insomnia

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2024-10-28 DOI:10.1016/j.sleep.2024.10.030

Nan Bai , Min Yin

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Abstract

Background

Despite the effectiveness of digital cognitive behavior therapy for insomnia (dCBT-I) in treating comorbid insomnia and depression, its accessibility and high dropout rates among adolescents and young adults remain significant limitations. A potential solution could be nurse-led dCBT-I. This study evaluates the feasibility and efficacy of nurse-led dCBT-I in reducing insomnia symptoms and improving mood in adolescents and young adults with depression.

Aims

Our objective was to evaluate the feasibility and effectiveness of a nurse-led dCBT-I in reducing insomnia severity among adolescents and young adults with depression.

Methods

A parallel-group randomized controlled trial involved 40 adolescents and young adults aged 14 to 24 with major depressive disorder and insomnia. They were assigned to receive either a nurse-led 6-week dCBT-I or usual care. The study evaluated outcomes such as insomnia severity, depression severity, and sleep parameters. Measurements were taken at baseline, immediately after the intervention (6 weeks), and during a follow-up at 18 weeks.

Results

The intention-to-treat analysis was performed using a generalized linear mixed model (GLMM). Results indicated that, compared to the control group, participants in the intervention group exhibited a significant reduction in insomnia severity at the 18-week follow-up, with a large effect size (Cohen's d = −0.965, p < 0.001). Additionally, the intervention group demonstrated a significant decrease in depression severity both at the end of the intervention (Cohen's d = −0.686, p = 0.001) and at the 18-week follow-up (Cohen's d = −0.508, p = 0.011), indicating a medium effect size.

Conclusions

Nurse-led dCBT-I is an effective treatment for adolescents and young adults with depression and insomnia.

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改善抑郁青少年的睡眠和情绪：以护士为主导的失眠数字认知行为疗法随机试验

背景尽管数字失眠认知行为疗法（dCBT-I）在治疗合并失眠和抑郁方面效果显著，但其在青少年和年轻成年人中的可及性和高辍学率仍然是其明显的局限性。护士主导的 dCBT-I 可能是一个潜在的解决方案。本研究评估了护士指导的 dCBT-I 在减轻青少年抑郁症患者的失眠症状和改善其情绪方面的可行性和有效性。他们被分配接受为期 6 周、由护士指导的 dCBT-I 或常规护理。研究评估了失眠严重程度、抑郁严重程度和睡眠参数等结果。结果采用广义线性混合模型（GLMM）进行了意向治疗分析。结果表明，与对照组相比，干预组的参与者在 18 周的随访中失眠严重程度明显降低，且效果显著（Cohen's d = -0.965, p <0.001）。此外，干预组的抑郁严重程度在干预结束时（Cohen's d = -0.686，p = 0.001）和 18 周随访时（Cohen's d = -0.508，p = 0.011）均有显著下降，显示出中等效应规模。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.