Michael Edmonds PhD

Treating comorbid insomnia in patients receiving transdiagnostic Internet-delivered cognitive behaviour therapy for anxiety and depression: A randomized controlled trial

PhD Thesis Results, Michael Edmonds 2023

• Can a brief intervention for insomnia offered alongside our existing internet-delivered therapy program (the Wellbeing Course) provide patients with additional benefit?
• Are sleep restriction (reduce time in bed to consolidate sleep) and stimulus control (limits activities patients do in their bed) helpful skills for patients taking the Wellbeing Course?

• 217 patients presenting with symptoms of depression or anxiety and insomnia were randomly assigned to Standard Wellbeing Course or Sleep-Enhanced Wellbeing Course.
• Patients completed pre-treatment, post-treatment, and 20-week follow-up questionnaires, including measures of symptoms of insomnia, depression, & anxiety.
• Patients completed brief measures during treatment to assess the use of sleep restriction and stimulus control.
• Feedback was gathered through a treatment satisfaction questionnaire.

• Patients in the Sleep-Enhanced Wellbeing Course Wellbeing Course reported larger reductions in insomnia than patients in the standard Wellbeing Course.
• Following sleep restriction guidelines was related to greater reductions in insomnia symptoms.
• Both groups reported improvements in generalized anxiety and depression.
• The most common factors impacting sleep reported by patients were anxiety, care responsibilities, and interruptions (woken up by noise/external factors).
• Patients were highly satisfied with the Sleep-Enhanced Wellbeing Course in terms of its understandability and helpfulness.

• A brief intervention targeting insomnia can be beneficial for patients seeking treatment for symptoms related to anxiety and depression, while maintaining effectiveness of the Wellbeing Course.
• Patient-oriented design of the new sleep resource produced an intervention that was understandable and helpful for patients.

Future Directions:
• Investigate what parts of the new Sleep-Enhanced Wellbeing Course are most important for symptom change.
• Offer individualized treatment plans that emphasize skills for insomnia for patients most likely to benefit.