Effects of nurse-led, web-based brief behavioral therapy on insomnia severity in patients in the chronic stage of stroke recovery: a preliminary randomized controlled trial.
Faizul Hasan, Era Catur Prasetya, Christopher James Gordon, Debby Syahru Romadlon, Kai-Mei Chang, Delwyn J Bartlett, Chia-Jou Lin, Made Satya Nugraha Gautama, Nur Izzati, Hsiao-Yean Chiu
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引用次数: 0
Abstract
Study objectives: Insomnia is prevalent among stroke survivors in the chronic stage of stroke. However, effective interventions remain limited. This study examined the effects of nurse-led, face-to-face, and web-based brief behavioral therapy for insomnia (BBTI) compared with sleep hygiene education (SHE) on sleep outcomes in stroke survivors.
Methods: A total of 45 stroke survivors were recruited from an outpatient clinic in Java, Indonesia, and randomly assigned (1:1:1) to either a face-to-face BBTI, web-based BBTI, or SHE group. Both BBTI interventions followed a standardized 4-week protocol delivered in person or through an online platform. The primary outcome was insomnia severity, measured using the Indonesian Insomnia Severity Index (ISI-INA). Secondary outcomes included sleep onset latency, wake after sleep onset, sleep efficiency, excessive daytime sleepiness, anxiety, depression, and fatigue. Data were analyzed using generalized estimating equations.
Results: The ISI-INA scores were significantly lower in the BBTI groups than in the SHE group. After 1 month, insomnia remission (ISI-INA score < 8) was achieved in 93.3% of the web-based BBTI group and 86.7% of the face-to-face BBTI group. These values were significantly higher than the 33.3% remission rate observed in the SHE group (P < .001). Improvements were observed in sleep onset latency, wake after sleep onset, and sleep efficiency. The BBTI groups reported reduced daytime sleepiness, although no significant changes in depression, anxiety, or fatigue were observed.
Conclusions: Nurse-led BBTI, whether in the face-to-face or web-based format, effectively reduces insomnia severity and improves sleep outcomes in stroke survivors, highlighting nurses' essential role in delivering sleep interventions.
期刊介绍：
Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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