A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease
Objective Poor sleep is common in inflammatory bowel disease (IBD), associated with worse overall disease course and predominantly attributable to insomnia. While cognitive–behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia, it is untested in IBD. I...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-10-01
|
| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/8/1/e000805.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846138129687248896 |
|---|---|
| author | Kelly A Aschbrenner Corey A Siegel Jessica K Salwen-Deremer Michael T Smith Hannah G Haskell Brittany C Speed |
| author_facet | Kelly A Aschbrenner Corey A Siegel Jessica K Salwen-Deremer Michael T Smith Hannah G Haskell Brittany C Speed |
| author_sort | Kelly A Aschbrenner |
| collection | DOAJ |
| description | Objective Poor sleep is common in inflammatory bowel disease (IBD), associated with worse overall disease course and predominantly attributable to insomnia. While cognitive–behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia, it is untested in IBD. It is unclear if CBT-I will be as effective in this group given the extent of night-time symptoms people with IBD experience. Thus, we evaluated the feasibility and preliminary efficacy of CBT-I in IBD.Design We comprehensively assessed sleep in people with mild-to-moderately active IBD using questionnaires, daily diaries and actigraphy. People with significant insomnia symptoms were allocated to a single-arm, uncontrolled pilot feasibility study of gold-standard CBT-I treatment. They were then reassessed post-treatment.Results 20 participants with IBD completed a baseline assessment. 10 were experiencing insomnia and were allocated to CBT-I. All participants who were offered CBT-I elected to complete it, and all completed 5/5 sessions. Participants rated treatment acceptability highly and daily diary and actigraphy completion rates were >95%. At baseline, participants with insomnia evidenced significantly worse sleep than participants without insomnia. Following CBT-I, participants reported significant improvements in diary and actigraphy measures of sleep continuity, dysfunctional sleep-related beliefs and IBD disease activity.Conclusion CBT-I was feasible and acceptable and demonstrated a signal for efficacy in the treatment of insomnia in IBD. Importantly, the improvements in sleep continuity were consistent with the extant literature. Future fully powered randomised controlled studies should evaluate whether treatment of insomnia can improve other aspects of IBD, including pain and inflammation.Trial registration number NCT04132024. |
| format | Article |
| id | doaj-art-dbfd696ca35b49fca3410bd4da51c9c7 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-dbfd696ca35b49fca3410bd4da51c9c72024-12-07T11:20:12ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2021-000805A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel diseaseKelly A Aschbrenner0Corey A Siegel1Jessica K Salwen-Deremer2Michael T Smith3Hannah G Haskell4Brittany C Speed5Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USACenter for Digestive Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USADepartment of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USADepartment of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USADepartment of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USADepartment of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USAObjective Poor sleep is common in inflammatory bowel disease (IBD), associated with worse overall disease course and predominantly attributable to insomnia. While cognitive–behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia, it is untested in IBD. It is unclear if CBT-I will be as effective in this group given the extent of night-time symptoms people with IBD experience. Thus, we evaluated the feasibility and preliminary efficacy of CBT-I in IBD.Design We comprehensively assessed sleep in people with mild-to-moderately active IBD using questionnaires, daily diaries and actigraphy. People with significant insomnia symptoms were allocated to a single-arm, uncontrolled pilot feasibility study of gold-standard CBT-I treatment. They were then reassessed post-treatment.Results 20 participants with IBD completed a baseline assessment. 10 were experiencing insomnia and were allocated to CBT-I. All participants who were offered CBT-I elected to complete it, and all completed 5/5 sessions. Participants rated treatment acceptability highly and daily diary and actigraphy completion rates were >95%. At baseline, participants with insomnia evidenced significantly worse sleep than participants without insomnia. Following CBT-I, participants reported significant improvements in diary and actigraphy measures of sleep continuity, dysfunctional sleep-related beliefs and IBD disease activity.Conclusion CBT-I was feasible and acceptable and demonstrated a signal for efficacy in the treatment of insomnia in IBD. Importantly, the improvements in sleep continuity were consistent with the extant literature. Future fully powered randomised controlled studies should evaluate whether treatment of insomnia can improve other aspects of IBD, including pain and inflammation.Trial registration number NCT04132024.https://bmjopengastro.bmj.com/content/8/1/e000805.full |
| spellingShingle | Kelly A Aschbrenner Corey A Siegel Jessica K Salwen-Deremer Michael T Smith Hannah G Haskell Brittany C Speed A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease BMJ Open Gastroenterology |
| title | A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease |
| title_full | A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease |
| title_fullStr | A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease |
| title_full_unstemmed | A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease |
| title_short | A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease |
| title_sort | pilot feasibility trial of cognitive behavioural therapy for insomnia in people with inflammatory bowel disease |
| url | https://bmjopengastro.bmj.com/content/8/1/e000805.full |
| work_keys_str_mv | AT kellyaaschbrenner apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT coreyasiegel apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT jessicaksalwenderemer apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT michaeltsmith apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT hannahghaskell apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT brittanycspeed apilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT kellyaaschbrenner pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT coreyasiegel pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT jessicaksalwenderemer pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT michaeltsmith pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT hannahghaskell pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease AT brittanycspeed pilotfeasibilitytrialofcognitivebehaviouraltherapyforinsomniainpeoplewithinflammatoryboweldisease |