AUTHOR=Pchelina Polina , Poluektov Mikhail 

TITLE=Duration of insomnia and success expectancy predict treatment outcome of iCBT for insomnia

JOURNAL=Frontiers in Sleep

VOLUME=3

YEAR=2024

URL=https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2024.1415077

DOI=10.3389/frsle.2024.1415077

ISSN=2813-2890

ABSTRACT=<sec><title>Introduction</title><p>Identifying prognostic factors of treatment outcome may assist in customizing an intervention to a patient's needs. Hence, we conducted a secondary analysis of data from a randomized controlled trial to investigate the effectiveness of an internet-based cognitive behavioral therapy for insomnia (iCBT-I) to find patient characteristics that may predict the change of insomnia severity after treatment.</p></sec><sec><title>Materials and methods</title><p>In this exploratory analysis involving 94 chronic insomnia patients, we examined the predictive value of several self-reported measures, medical history, and sociodemographic variables to psychological distress with separate linear regression models. The main outcome was the Insomnia Severity Index score improvement from pre- to post-treatment</p></sec><sec><title>Results</title><p>The study found that duration of insomnia, <italic>b</italic> (<italic>SE</italic>) = −0.02 (0.01), <italic>p</italic> = 0.01, and attitudes about the expected treatment success, <italic>b</italic> (<italic>SE</italic>) = 0.80 (0.27), <italic>p</italic> = 0.004, were predictors of a better outcome. Moreover, a better outcome was associated with a lower level of the following traits: attention seeking, <italic>b</italic> (<italic>SE</italic>) = −1.06 (0.51), <italic>p</italic> = 0.04; grandiosity, <italic>b</italic> (<italic>SE</italic>) = −1.50 (0.57), <italic>p</italic> = 0.01; distractibility, <italic>b</italic> (<italic>SE</italic>) = −1.57 (0.75), <italic>p</italic> = 0.04; and rigid perfectionism, <italic>b</italic> (<italic>SE</italic>) = −1.32 (0.65), <italic>p</italic> = 0.05.</p></sec><sec><title>Conclusion</title><p>Our results suggest that iCBT-I might be particularly beneficial for patients with higher expectations from the therapy and those who have a shorter duration of insomnia. Some pronounced personality traits, such as attention seeking, grandiosity, distractibility, and rigid perfectionism, may predict worse outcomes. However, because this was a <italic>post-hoc</italic> analysis, our results must be considered exploratory and verified in further studies.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/study/NCT04300218?cond=NCT04300218&amp;rank=1" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/study/NCT04300218?cond=NCT04300218&amp;rank=1</ext-link>, Identifier NCT04300218.</p></sec>