Internet-Based Cognitive Behavioral Therapy for Insomnia (ICBT-i) Improves Comorbid Anxiety and Depression—A Meta-Analysis of Randomized Controlled Trials

• Published in: PloS one Vol. 10; no. 11; p. e0142258
• Main Authors: Ye, Yuan-yuan, Zhang, Yuan-feng, Chen, Jia, Liu, Juan, Li, Xun-jun, Liu, Ya-zhen, Lang, Ying, Lin, Ling, Yang, Xin-Ju, Jiang, Xiao-Jiang
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.11.2015; Public Library of Science (PLoS)
• Subjects: Anxiety; Anxiety Disorders - therapy; Behavior modification; Care and treatment; Clinical trials; Cognitive ability; Cognitive behavioral therapy; Cognitive Therapy; Comorbidity; Complications and side effects; Confidence intervals; Depression (Mood disorder); Depressive Disorder - physiopathology; Depressive Disorder - therapy; Gaming machines; Hospitals; Humans; Insomnia; Internet; Mental depression; Meta-analysis; Neurology; Older people; Randomization; Randomized Controlled Trials as Topic; Risk factors; Sleep disorders; Sleep Initiation and Maintenance Disorders - physiopathology; Sleep Initiation and Maintenance Disorders - therapy; Studies; Telemedicine; Therapy; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0142258

As the internet has become popularized in recent years, cognitive behavioral therapy for insomnia (CBT-i) has shifted from a face-to-face approach to delivery via the internet (internet-based CBT-i, ICBT-i). Several studies have investigated the effects of ICBT-i on comorbid anxiety and depression; however, the results remain inconclusive. Thus, a meta-analysis was conducted to determine the effects of ICBT-i on anxiety and depression. Electronic databases, including PubMed, EMBASE, PsycINFO and the Cochrane Library (throughout May 28, 2015), were systematically searched for randomized controlled trials (RCTs) of ICBT-i. Data were extracted from the qualified studies and pooled together. The standardized mean difference (SMD) and 95% confidence interval (95% CI) were calculated to assess the effects of ICBT-i on comorbid anxiety and depression. Nine records that included ten studies were ultimately qualified. The effect sizes (ESs) were -0.35 [-0.46, -0.25] for anxiety and -0.36 [-0.47, -0.26] for depression, which were stable using a between-group or within-group comparison and suggest positive effects of ICBT-i on both comorbid disorders. Although positive results were identified in this meta-analysis, additional high-quality studies with larger sample sizes are needed in the future.