How Does E-mail-Delivered Cognitive Behavioral Therapy Work for Young Adults (18–28 Years) with Insomnia? Mediators of Changes in Insomnia, Depression, Anxiety, and Stress

Ayaka Ubara, Noriko Tanizawa, Megumi Harata, Sooyeon Suh, Chien-Ming Yang, Xin Li and Isa Okajima
Additional contact information
Ayaka Ubara: Graduate School of Psychology, Doshisha University, Kyoto 610-0321, Japan
Noriko Tanizawa: Department of Innovation Laboratories, NEC Solution Innovators, Ltd., Tokyo 136-8627, Japan
Megumi Harata: Public Children Support Center, Adachi-ku, Tokyo 121-0816, Japan
Sooyeon Suh: Department of Psychology, Sungshin Women’s University, Seoul 02844, Korea
Chien-Ming Yang: Department of Psychology, National Chengchi University, Taipei 11605, Taiwan
Xin Li: Department of Psychology, The University of Hong Kong, Hong Kong, China
Isa Okajima: Department of Psychological Counseling, Tokyo Kasei University, Tokyo 173-8602, Japan

IJERPH, 2022, vol. 19, issue 8, 1-10

Abstract: This study examined whether cognitive behavioral therapy (CBT) for insomnia (CBT-I) improved insomnia severity, by changing sleep-related mediating factors. It also examined whether an improvement in insomnia led to enhanced mental health. This study was a secondary analysis of a randomized controlled trial of e-mail-delivered CBT-I for young adults with insomnia. The participants were randomized to either CBT-I or self-monitoring. The mental health-related measures were depression, anxiety, and stress. The sleep-related mediating factors were sleep hygiene practices, dysfunctional beliefs, sleep reactivity, and pre-sleep arousal. A total of 41 participants, who completed all the sessions (71% females; mean age 19.71 ± 1.98 years), were included in the analysis. The hierarchical multiple regression analysis showed that 53% of the variance in the improvements in insomnia severity was explained by the treatment group ( β = −0.53; Δ R 2 = 0.25; p < 0.01) and the changes in sleep reactivity ( β = 0.39; Δ R 2 = 0.28; p < 0.05). Moreover, the mediation analysis showed that the reductions in depression and stress were explained by the changes in insomnia severity; however, anxiety symptoms were not reduced. CBT-I for young adults suggested that sleep reactivity is a significant mediator that reduces insomnia severity, and that the alleviation and prevention of depression and stress would occur with the improvement in insomnia.

Keywords: insomnia; depression; anxiety; stress; cognitive behavioral therapy; mediator; college students (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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