Reducing levels of depressive symptoms with CBT for insomnia? Results from a randomized controlled trial of face-to-face vs online CBT-I for insomnia-patients
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- Institutt for psykologi 
Aims: The current study has two main aims; (1) Investigate whether there is a reduction in levels of depressive symptoms with CBT-I treatment, and if online CBT-I (SHUTi) and faceto-face CBT-I have different effects on levels of depressive symptoms. (2) Test the relationship between initial levels of as well as change in insomnia severity and levels of depressive symptoms at follow-up. Methods: This study is based on data from a randomized controlled trial comparing online CBT-I (SHUTi) to face-to-face CBT-I regarding effects on insomnia. Levels of depressive symptoms and insomnia severity were assessed before treatment, after treatment, and at six months follow-up. Linear mixed model was used to analyze aim 1 and hierarchical regression analysis was used to analyze aim 2. Results: There was a significant reduction in self-reported depressive symptoms over time for both treatments (F(2,180)=14.4, p< 0.001), and no significant differences between treatments (F(2,180)=0.89, p=0.92). There were significant associations between initial insomnia severity and levels of depressive symptoms at follow-up (β=0.23, p=0.001), between change in insomnia severity during treatment and levels of depressive symptoms at follow-up (β=0.26, p<0.001). Conclusion: CBT-I, both delivered face-to-face and online, show promising results in reducing levels of depressive symptoms in patients with insomnia disorder. Both initial insomnia severity and improvement in insomnia severity seem to predict depressive outcomes. This indicates that CBT-I may be useful in prevention and treatment of depressive symptoms in patients with insomnia disorder.