Evidence map›Paper›PMID 22264332›Full record

Trial reportBMC psychiatry2012

Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia--a randomized controlled trial.

Susanna Jernelöv, Mats Lekander, Kerstin Blom, Sara Rydh, Brjánn Ljótsson, John Axelsson, Viktor Kaldo

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01105052 (Cognitive Behavioral Therapy as Guided Self-help for Insomnia - a Randomized Controlled Trial), which is not on this map. Cited by 40 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 7 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01105052 nacompletednot on this map

Cognitive Behavioral Therapy as Guided Self-help for Insomnia - a Randomized Controlled Trial

TypeinterventionalSponsorKarolinska InstitutetRan2008 to 2009Enrolled133ConditionsInsomniaArmsSelf-help CBT-I
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 7 syntheses or guidelines pooled it, 126 citations in OpenAlex.

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  7. Cognitive and Behavioral Interventions to Improve Sleep in School-Age Children and Adolescents: A Systematic Review and Meta-Analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Susanna JernelövDepartment of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden. Susanna.Jernelov@ki.se
Mats Lekander
Kerstin Blom
Sara Rydh
Brjánn Ljótsson
John Axelsson
Viktor Kaldo
Karolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support.

methodsVolunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index.

resultsIntention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's < .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up.

conclusionsParticipants receiving self-help for insomnia benefited markedly. Self-help, especially if therapist-supported, has considerable potential to be as effective as individual treatment at lower cost, also for individuals with co-morbid problems.

trial registrationClinicalTrials.gov: NCT01105052.

Indexed as

AdultAgedBibliotherapyCognitive Behavioral TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedPatient ComplianceRemote ConsultationSelf CareSelf ReportSleep Initiation and Maintenance DisordersSurveys and QuestionnairesTreatment Outcome

Identifiers

PMID22264332
PMCPMC3328261
OpenAlexW2026342526

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.