Cognitive Behavioral Therapy for Insomnia in China: A Knowledge, Attitude, and Practice Study Among Medical Doctors Treating Patients with Insomnia.

Objectives: Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first-line treatment for insomnia disorders, yet its clinical application rate ranges from 1% to 29%. This study evaluated medical doctors' knowledge, attitudes, and practices regarding the use of CBT-I in treatingpatients with insomnia.

Methods: A cross-sectional study was conducted from May 8 to 26, 2021. Data were collected using an anonymous structured self-administered questionnaire with 19 questions. Multivariable logistic regression analysis identified factors influencing doctors' recommendations of CBT-I.

Results: The sample included 1494 respondents.Of these, 27.2% knew the core components of CBT-I, 86.1% believed it was a first-line treatment, and 64.1% had recommended CBT-I. The analysis indicated that female respondents were less likely to recommend CBT-I (adjusted OR = 0.76, p = .045), whereas those aged 31-40 years were more likely to recommend it (adjusted OR = 2.62, p < .001). Respondents with an undergraduate degree or lower (adjusted OR = 1.36, p = .043), those knowledgeable about stimulus control (adjusted OR = 0.67, p = .01), familiar with CBT-I (adjusted OR = 0.09, p < .001), and who viewed CBT-I as a first-line treatment (adjusted OR = 0.37, p < .001) were more inclined to recommend it.

Conclusions: Medical doctors treating insomnia have positive attitudes toward CBT-I but need better knowledge. Factors influencing CBT-I recommendations include gender, age, education level, knowledge of stimulus control, familiarity with CBT-I, and viewing it as a first-line treatment. These findings highlight the need for targeted education to improve CBT-I adoption.