Online Cognitive Behavior Therapy for Comorbid Sleep Problems in Alcohol Use Disorder

Online Cognitive Behavior Therapy in Routine Addiction Care for Comorbid Sleep Problems in Alcohol Use Disorder

The main goal is to study the effects of internet-delivered cognitive behavioural therapy with minimum guidance for comorbid sleep problems in alcohol use disorder, in routine addiction care.

Alcohol use disorder (AUD) is highly prevalent and a major contributor to the global burden of disease. Insomnia symptoms are very common among individuals with AUD, including those in recovery, which may in turn promote alcohol relapse. Specialization and silo phenomena in healthcare organization, separating addiction from other types of psychiatric care, means that individuals with AUD and comorbid sleep problems often have difficulty accessing evidence-treatment for the latter. Offering online treatment for sleep problems to individuals enrolled in traditional routine addiction care is an attractive and pragmatic approach to offering parallel treatments covering the full clinical presentation, which has not yet been evaluated. This pilot and feasibility trial will recruit n=25 from patients in routine addiction care with comorbid sleep problems and AUD, who will complete an online, ten-module, CBT-based treatment program with minimum guidance for sleep problems, tailored for individuals with AUD.

The ten modules cover: Psychoeducation about sleep, sleep problems, and associations with alcohol How to keep and use a sleep diary Sleep hygiene Sleep compression Cognitive restructuring Emotional regulation Preparing for the future

Total score of the two-item SCI, assessing last-week symptoms. Administered on the treatment platform.

Change in score on the full and regular SCI. Administered through the online survey tool connected to regular patient records system.

Change from baseline (pre-treatment), post-treatment (primary endpoint, 10-15 weeks after baseline), and follow-up three months after baseline..

Derived measures: last-week average sleep efficiency, time to fall asleep, time awake at night, total sleep time.

Change from baseline (pre-treatment), post-treatment (primary endpoint, 10-15 weeks after baseline), and follow-up three months after baseline..

Change from baseline (pre-treatment), post-treatment (primary endpoint, 10-15 weeks after baseline), and follow-up three months after baseline..

Change from baseline (pre-treatment), post-treatment (primary endpoint, 10-15 weeks after baseline), and follow-up three months after baseline..

Change from baseline (pre-treatment), post-treatment (primary endpoint, 10-15 weeks after baseline), and follow-up three months after baseline..

Inclusion Criteria: Enrolled patient at Stockholm Center for Dependency Disorders Diagnosed alcohol use disorder Self-rated sleep problem Exclusion Criteria: Addiction to sedative or hypnotic medication Psychoactive medication not yet 3-month stable in dose Bipolar disorder Psychotic disorder Suicidality Periodic Limb Movement Disorder (PLMD) Sleep apnea

Raw outcomes, with any other identifiable information, may be shared under the conditions described below.

Kaldo V, Jernelov S, Blom K, Ljotsson B, Brodin M, Jorgensen M, Kraepelien M, Ruck C, Lindefors N. Guided internet cognitive behavioral therapy for insomnia compared to a control treatment - A randomized trial. Behav Res Ther. 2015 Aug;71:90-100. doi: 10.1016/j.brat.2015.06.001. Epub 2015 Jun 3.