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

Isa Okajima, Noriko Tanizawa, Megumi Harata, Sooyeon Suh, Chien-Ming Yang, Shirley Xin Li and Mickey T. Trockel
Additional contact information
Isa Okajima: Department of Psychological Counseling, Tokyo Kasei University, Tokyo 173-8602, 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
Mickey T. Trockel: Department of Psychiatry, Stanford University, Palo Alto, CA 94305, USA

IJERPH, 2021, vol. 19, issue 1, 1-11

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.

Keywords: insomnia; depression; anxiety; self-help; cognitive behavioral therapy; self-monitoring (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2021:i:1:p:186-:d:710656

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