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Can an E-Mail-Delivered CBT for Insomnia Validated in the West Be Effective in the East? A Randomized Controlled Trial

Author

Listed:
  • Isa Okajima

    (Department of Psychological Counseling, Tokyo Kasei University, Tokyo 173-8602, Japan
    Faculty of Human Sciences, Waseda University, Saitama 359-1192, Japan)

  • Noriko Tanizawa

    (Department of Innovation Laboratories, NEC Solution Innovators, Ltd., Tokyo 136-8627, Japan)

  • Megumi Harata

    (Public Children Support Center at Adachi-ku, Tokyo 121-0816, Japan)

  • Sooyeon Suh

    (Department of Psychology, Sungshin Women’s University, Seoul 02844, Korea)

  • Chien-Ming Yang

    (The Research Center for Mind, Department of Psychology, Brain & Learning, National Chengchi University, Taipei 11605, Taiwan)

  • Shirley Xin Li

    (Department of Psychology, The University of Hong Kong, Hong Kong, China
    The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China)

  • Mickey T. Trockel

    (Department of Psychiatry, Stanford University, Palo Alto, CA 94305, USA)

Abstract

This study examined the effects of an e-mail-delivered cognitive behavioral therapy for insomnia (CBT-I), validated in Western countries, on insomnia severity, anxiety, and depression in young adults with insomnia in Eastern countries, particularly Japan. This prospective parallel-group randomized clinical trial included college students with Insomnia Severity Index (ISI) scores of ten or higher. Participants were recruited via advertising on a university campus and randomized to an e-mail-delivered CBT-I (REFRESH) or self-monitoring (SM) with sleep diaries group. The primary outcomes were insomnia severity, anxiety, and depression; secondary outcomes were sleep hygiene practices, dysfunctional beliefs, sleep reactivity, and pre-sleep arousal. All measurements were assessed before and after the intervention. A total of 48 participants (mean (SD) age, 19.56 (1.86) years; 67% female) were randomized and included in the analysis. The results of the intent-to-treat analysis showed a significant interaction effect for insomnia severity, anxiety, depression, sleep hygiene practice, and pre-sleep arousal. Compared with the SM group, the REFRESH group was more effective in reducing insomnia severity (Hedges’ g = 1.50), anxiety (g = 0.97), and depression (g = 0.61) post-intervention. These findings suggest that an e-mail-delivered CBT-I may be an effective treatment for young adults with elevated insomnia symptoms living in Japan.

Suggested Citation

  • Isa Okajima & Noriko Tanizawa & Megumi Harata & Sooyeon Suh & Chien-Ming Yang & Shirley Xin Li & Mickey T. Trockel, 2021. "Can an E-Mail-Delivered CBT for Insomnia Validated in the West Be Effective in the East? A Randomized Controlled Trial," IJERPH, MDPI, vol. 19(1), pages 1-11, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:186-:d:710656
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