Patient perceptions of digital and therapist-led CBT for insomnia: A qualitative study.

Gumport NB, Tully IA, Tutek J, Dietch JR, Zulman DM, Rosas LG, Simpson N, Manber R. Patient perceptions of digital and therapist-led CBT for insomnia: A qualitative study. Behavioral sleep medicine. 2024 Aug 3; 22(6):932-948.

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Abstract:

OBJECTIVES: Technology has the potential to increase access to evidence-based insomnia treatment. Patient preferences/perceptions of automated digital cognitive behavior therapy for insomnia (CBTI) and telehealth-delivered CBTI remain largely unexplored among middle-aged and older adults. Using a qualitative approach, the current study describes patients'' reasons for participating in the clinical trial, preferences for digital CBTI (dCBTI) versus therapist-led CBTI, patient attitudes toward dCBTI, and patient attitudes toward telehealth-delivered therapist-led CBTI. METHOD: Middle-aged and older adults (? = 80) completed a semi-structured interview before CBTI exposure. Qualitative responses were coded, and themes were inductively extracted. RESULTS: Most (62.5%) of the participants expressed a preference for therapist-led CBTI to dCBTI. Convenience was the most commonly reported advantage of dCBTI (? = 55) and telehealth-delivered CBTI (? = 65). Decreasing transit time and pandemic-related health concerns were identified as advantages to dCBTI and telehealth-delivered CBTI. Lack of human connection and limited personalization were perceived as disadvantages of dCBTI. Only three participants reported technological barriers to dCBTI and telehealth-delivered CBTI. CONCLUSION: Findings suggest that, despite an overall preference for therapist-led treatment, most middle-aged and older adults are open to dCBTI. As both dCBTI and telehealth-delivered CBTI are perceived as convenient, these modalities offer the potential to increase access to insomnia care.