The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol

BackgroundInsomnia is often accompanied by depression and anxiety, which can seriously affect people’s quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, but the existing CBT-I ignores the intervention for anxiety-depressive symptoms, and has poor efficac...

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Main Authors: Yating Zhao, Fangmei Ge, Xin Luo, Jingru Li, Jing Zhang, Yi Ju, Jie Zhang, Yong Wang, Dongbin Lyu, Yiren Qiu, Chengmei Yuan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1450275/full
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author Yating Zhao
Fangmei Ge
Xin Luo
Jingru Li
Jing Zhang
Yi Ju
Jie Zhang
Yong Wang
Dongbin Lyu
Yiren Qiu
Chengmei Yuan
author_facet Yating Zhao
Fangmei Ge
Xin Luo
Jingru Li
Jing Zhang
Yi Ju
Jie Zhang
Yong Wang
Dongbin Lyu
Yiren Qiu
Chengmei Yuan
author_sort Yating Zhao
collection DOAJ
description BackgroundInsomnia is often accompanied by depression and anxiety, which can seriously affect people’s quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, but the existing CBT-I ignores the intervention for anxiety-depressive symptoms, and has poor efficacy due to the lack of artificial support, poor compliance, the inability to spread widely and high dropping rate. A balance is needed between the convenience and efficiency of web-based technology and patient needs. Again in this context, an online WeChat applet (Smart CBT-I plus) will be developed with CBT-I technology as the core, integrating cognitive behavioral intervention modules for depression and anxiety.ObjectivesThis study will validate the effectiveness and applicability of Smart CBT-I plus by examining whether the Smart CBT-I plus study group will significantly reduce the distress of people suffering from insomnia with anxiety and/or depression symptoms compared to the psychoeducational group.MethodsIn this parallel-group, randomized controlled trial, 180 patients seeking help for insomnia combined with anxiety and/or depression will be recruited, and they will be randomized with 60 patients being assigned to the psychoeducation group (control group), and 120 patients being assigned to the Smart CBT-I plus group (study group). Measurements will be taken at baseline, post-intervention, 6 and 12 month follow-up, at the same time, semi-structured qualitative interviews about the experience of using Smart CBT-I plus will be conducted with randomly selected patients from the study group.ResultsThe results will involve insomnia, depression and anxiety to explore its effectiveness, in-treatment dropout rates and subjective patient feedback to explore the applicability of Smart CBT-I plus.Future recommendationsSelf-help platforms need to be more individually designed to reach a wider audience. Research aimed at a wider audience, such as the general public, will make the research more universal and the platform more meaningful.
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spelling doaj-art-bfb7493d033c47b8975bf5e9bec75c532025-08-20T02:48:41ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-03-011610.3389/fpsyt.2025.14502751450275The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocolYating Zhao0Fangmei Ge1Xin Luo2Jingru Li3Jing Zhang4Yi Ju5Jie Zhang6Yong Wang7Dongbin Lyu8Yiren Qiu9Chengmei Yuan10Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Putuo Mental Health Center, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackgroundInsomnia is often accompanied by depression and anxiety, which can seriously affect people’s quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, but the existing CBT-I ignores the intervention for anxiety-depressive symptoms, and has poor efficacy due to the lack of artificial support, poor compliance, the inability to spread widely and high dropping rate. A balance is needed between the convenience and efficiency of web-based technology and patient needs. Again in this context, an online WeChat applet (Smart CBT-I plus) will be developed with CBT-I technology as the core, integrating cognitive behavioral intervention modules for depression and anxiety.ObjectivesThis study will validate the effectiveness and applicability of Smart CBT-I plus by examining whether the Smart CBT-I plus study group will significantly reduce the distress of people suffering from insomnia with anxiety and/or depression symptoms compared to the psychoeducational group.MethodsIn this parallel-group, randomized controlled trial, 180 patients seeking help for insomnia combined with anxiety and/or depression will be recruited, and they will be randomized with 60 patients being assigned to the psychoeducation group (control group), and 120 patients being assigned to the Smart CBT-I plus group (study group). Measurements will be taken at baseline, post-intervention, 6 and 12 month follow-up, at the same time, semi-structured qualitative interviews about the experience of using Smart CBT-I plus will be conducted with randomly selected patients from the study group.ResultsThe results will involve insomnia, depression and anxiety to explore its effectiveness, in-treatment dropout rates and subjective patient feedback to explore the applicability of Smart CBT-I plus.Future recommendationsSelf-help platforms need to be more individually designed to reach a wider audience. Research aimed at a wider audience, such as the general public, will make the research more universal and the platform more meaningful.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1450275/fullonline self-help interventioninsomnia comorbidities anxiety and/or depressionrandomized controlled trialcognitive behavioral treatment of insomniaprotocoleffectiveness and applicability
spellingShingle Yating Zhao
Fangmei Ge
Xin Luo
Jingru Li
Jing Zhang
Yi Ju
Jie Zhang
Yong Wang
Dongbin Lyu
Yiren Qiu
Chengmei Yuan
The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
Frontiers in Psychiatry
online self-help intervention
insomnia comorbidities anxiety and/or depression
randomized controlled trial
cognitive behavioral treatment of insomnia
protocol
effectiveness and applicability
title The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
title_full The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
title_fullStr The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
title_full_unstemmed The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
title_short The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
title_sort applicability and effectiveness of the cognitive behavioral therapy for insomnia smart cbt i plus online program in patients with insomnia disorder combined with anxiety and depression a randomized controlled trial protocol
topic online self-help intervention
insomnia comorbidities anxiety and/or depression
randomized controlled trial
cognitive behavioral treatment of insomnia
protocol
effectiveness and applicability
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1450275/full
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