Cognitive-behavioral treatment for insomnia and mindfulness-based stress reduction in nurses with insomnia: a non-inferiority internet delivered randomized controlled trial.
Study Goal
The researchers aimed to determine if internet-delivered mindfulness-based stress reduction (IMBSR) was noninferior to internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) in reducing insomnia severity among nurses.
Results Summary
IMBSR significantly reduced insomnia severity and depression but was less effective than ICBT-I, which showed superior results in reducing insomnia severity and depression. Both interventions improved mindfulness, and nurses reported high satisfaction with both.
Population
Nurses with insomnia
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
internet-delivered mindfulness-based stress reduction (IMBSR) | decrease | insomnia severity | nurses with insomnia | - | significantly reduced | #1 |
internet-delivered mindfulness-based stress reduction (IMBSR) | decrease | depression | nurses with insomnia | - | significantly reduced | #2 |
internet-delivered mindfulness-based stress reduction (IMBSR) | increase | FFMQ-15 score | nurses with insomnia | Cohen's d = 0.67 | showed a statistically significant increase | #3 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | decrease | ISI score | nurses with insomnia | Cohen's d = 1.37 | had significantly lower | #4 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | decrease | PHQ-9 score | nurses with insomnia | Cohen's d = 0.71 | had significantly lower | #5 |
internet-delivered mindfulness-based stress reduction (IMBSR) | decrease | insomnia severity | nurses with insomnia | - | was effective at reducing | #6 |
internet-delivered mindfulness-based stress reduction (IMBSR) | decrease | depression severity | nurses with insomnia | - | was effective at reducing | #7 |
internet-delivered mindfulness-based stress reduction (IMBSR) | increase | mindfulness | nurses with insomnia | - | was effective at improving | #8 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | decrease | insomnia severity | nurses with insomnia | - | was effective at reducing | #9 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | decrease | depression severity | nurses with insomnia | - | was effective at reducing | #10 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | increase | mindfulness | nurses with insomnia | - | was effective at improving | #11 |
internet-delivered cognitive behavioral therapy for insomnia (ICBT-I) | decrease | insomnia severity | nurses with insomnia | - | was found to be significantly superior to the IMBSR in reducing | #12 |
BACKGROUND: Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I). OBJECTIVE: The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR. METHOD: Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I). RESULTS: The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness. CONCLUSION: Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.