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Therapist-Directed VS Online Therapy for Insomnia Co-Occurring With Sleep Apnea

January 7, 2021

Overview

The Therapist-Directed VS Online Therapy for Insomnia Co-Occurring With Sleep Apnea study aims to test the effectiveness of three different insomnia treatments in patients with sleep apnea: online cognitive behavioral therapy, therapist-directed cognitive therapy, and standard clinical care. 

 

Study Information 

Participants will either receive standard clinical care or standard clinical care in addition to online cognitive behavioral therapy (OCBT). Standard clinical care will involve PAP therapy as well as instruction in proper sleep hygiene. Patients who do not experience symptom relief from OCBT after 8 weeks will undergo a second stage: extended OCBT or therapist-directed cognitive therapy (TCBT). 

Those who will take part in the second stage will be reassessed 8 weeks later and attend follow-up appointments in the subsequent 3 and 6 months. 

 

Inclusion Criteria

 

  • Over 21 years old
  • Diagnosed with obstructive sleep apnea (OSA) with an AHI of greater than 5
  • Must use PAP as their main OSA therapy and have a prescription for PAP that has been filled in the last 3 months. In addition,  the participant must have used PAP for at least one month for an average of more than one hour per night.
  • Have sleep difficulties lasting more than 3 months regardless of having the opportunity to sleep. Participant must have daytime impairment due to poor sleep as well.
  • Must have insomnia severity index score of greater than 10
  • Must have sleep onset latency of more than 30 minutes for 3 or more nights per week, during two weeks of keeping a sleep diary

 

Exclusion Criteria

 

  • Untreated psychiatric disorder
  • Diagnosis of psychotic or bipolar disorder
  • Risk of suicide 
  • Has abused drugs or alcohol in the past year
  • Terminal illness or neurological degenerative disease
  • Takes medications known to cause insomnia
  • Comorbid narcolepsy, idiopathic hypersomnia, restless legs syndrome, periodic limb movement during sleep, or a circadian rhythm sleep disorder
  • Drinks more than two alcoholic beverages per day
  • Drinks more than 10 caffeinated beverages per day
  • Uses marijuana more than once per week or after 4 PM
  • Has changed thyroid medication dosage or received a new prescription for thyroid medication 3 months before screening 
  • Has a seizure disorder

 

Locations

Stanford University

Palo Alto, California, United States

 

National Jewish Health

Denver, Colorado, United States

 

Sponsors / Collaborators

National Jewish Health

Stanford University

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