TY  - JOUR
AU  - Reilly, Erin Dawna
AU  - Robinson, Stephanie A
AU  - Petrakis, Beth Ann
AU  - Gardner, Melissa M
AU  - Wiener, Renda Soylemez
AU  - Castaneda-Sceppa, Carmen
AU  - Quigley, Karen S
PY  - 2021
DA  - 2021/12/9
TI  - Mobile Intervention to Improve Sleep and Functional Health of Veterans With Insomnia: Randomized Controlled Trial
JO  - JMIR Form Res
SP  - e29573
VL  - 5
IS  - 12
KW  - cognitive behavioral therapy
KW  - mobile app
KW  - physical activity
KW  - insomnia
AB  - Background: Insomnia is a prevalent and debilitating disorder among veterans. Cognitive behavioral therapy for insomnia (CBTI) can be effective for treating insomnia, although many cannot access this care. Technology-based solutions and lifestyle changes, such as physical activity (PA), offer affordable and accessible self-management alternatives to in-person CBTI. Objective: This study aims to extend and replicate prior pilot work to examine whether the use of a mobile app for CBTI (cognitive behavioral therapy for insomnia coach app [CBT-i Coach]) improves subjective and objective sleep outcomes. This study also aims to investigate whether the use of the CBT-i Coach app with adjunctive PA improves sleep outcomes more than CBT-i Coach alone. Methods: A total of 33 veterans (mean age 37.61 years, SD 9.35 years) reporting chronic insomnia were randomized to use either the CBT-i Coach app alone or the CBT-i Coach app with a PA intervention over 6 weeks, with outcome measures of objective and subjective sleep at pre- and posttreatment. Results: Although the PA manipulation was unsuccessful, both groups of veterans using the CBT-i Coach app showed significant improvement from baseline to postintervention on insomnia (P<.001), sleep quality (P<.001), and functional sleep outcomes (P=.002). Improvements in subjective sleep outcomes were similar in those with and without posttraumatic stress disorder and mild-to-moderate sleep apnea. We also observed a significant but modest increase in objective sleep efficiency (P=.02). Conclusions: These findings suggest that the use of a mobile app–delivered CBTI is feasible and beneficial for improving sleep outcomes in veterans with insomnia, including those with comorbid conditions such as posttraumatic stress disorder or mild-to-moderate sleep apnea. Trial Registration: ClinicalTrials.gov NCT03305354; https://clinicaltrials.gov/ct2/show/NCT03305354 
SN  - 2561-326X
UR  - https://formative.jmir.org/2021/12/e29573
UR  - https://doi.org/10.2196/29573
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34889746
DO  - 10.2196/29573
ID  - info:doi/10.2196/29573
ER  -