Internet-based CBT treatment improves sleep, according to a new dissertation

On May 20, Sandra Öberg, School of Health and Welfare at Jönköping University, defended her dissertation "The Hit-IT project: The development and evaluation of an internet-based complex intervention for primary healthcare patients with cardiovascular disease and insomnia". The aim of the dissertation was to develop and evaluate a nurse-led internet-based cognitive behavioral therapy (CBT treatment), specifically designed for patients with cardiovascular disease and insomnia.

Sandra Öberg

The dissertation, which consists of four different research papers, was based partly on interviews with primary care patients with cardiovascular disease, and partly on questionnaires in which patients were asked questions about demography, lifestyle, sleep quality and physical and mental health. The dissertation also includes a randomized controlled study for the evaluation of the effect of the internet-based CBT program.

"A significant improvement"

The results showed that more severe insomnia was related to a higher degree of depressive symptoms and somatic symptom disorders (a mental health condition in which a person feels significantly distressed about physical symptoms and has abnormal thoughts, feelings and behaviors in response to them), as well as to a poorer physical and mental quality of life. The participants in the study experienced that sleep was affected by heart disease-related symptoms at night and this led to worry and anxiety problems. The participants who underwent the nine-week nurse-led CBT treatment had a significantly improved sleep compared with the control group, who were allowed to take part in a three-week self-study program without nurse support.

“The nurse-led internet-based CBT treatment showed a significant improvement in the sleep of the study participants, an improvement that persisted six months after the end of treatment,” says Sandra Öberg.

According to the participants, the CBT program was very well designed, and they had high hopes that it would actually work to improve the sleep.

“The dissertation will hopefully provide increased knowledge and a basis for further development of nurse-led internet-based interventions in healthcare. This is to increase the availability of treatment and improve sleep and the quality of life for patients living with cardiovascular disease and insomnia,” says Sandra Öberg.

Will continue to research

Sandra Öberg is trained as a specialist nurse in oncology and has previously worked in cancer care. In 2016, she became a doctoral student at the School of Health and Welfare, where she also works as a lecturer at the Department of Nursing.

“After my dissertation, I will continue to teach on the Nursing programme at the School of Health and Welfare, but I will also continue to do research on insomnia and hopefully further expand the knowledge about sleep and sleep health from both a patient and caregiver perspective,” says Sandra Öberg.

The main supervisor was Professor Anders Broström, School of Health and Welfare, and Professor Staffan Karlsson, Kristianstad University, acted as opponent.

Read the dissertation here