Ritterband Lee M, Shaffer Kelly M, Thorndike Frances P, Chow Philip I, Gonder-Frederick Linda, Ingersoll Karen S, Cohn Wendy F, Frederick Christina, MacDonnell Kirsten, Glazer Jillian V, Mattos Meghan K, Hilgart Michelle M, Quigg Mark S, Bashir Mudhasir, Morin Charles M
Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
Nox Health Inc., Alpharetta, GA, USA.
NPJ Digit Med. 2025 Jul 19;8(1):458. doi: 10.1038/s41746-025-01847-0.
Older adults with insomnia face considerable challenges accessing treatment given limited availability to first-line therapy (Cognitive-Behavioral Therapy for Insomnia, CBT-I). This study evaluated the efficacy of Sleep Healthy Using the Internet for Older Adults Suffering with Insomnia and Sleeplessness (SHUTi OASIS), a tailored CBT-I internet intervention for older adults with insomnia, in a 3-arm randomized controlled trial (SHUTi OASIS alone, SHUTi OASIS + stepped support, online patient education [PE]). 311 participants (ages 55-95) were randomized to receive SHUTi OASIS (alone n = 105; with stepped support n = 102), with both conditions reporting significant improvements across post, 6-month, and 12-month follow-ups in insomnia severity compared to those receiving PE (n = 104). Clinically meaningful indices of insomnia response and remission were also higher among those receiving SHUTi OASIS. Those who received SHUTi OASIS also significantly outperformed those receiving PE on secondary outcomes, including sleep onset latency, wake after sleep onset, sleep efficiency, number of awakenings, sleep quality, and fatigue, across most timepoints. Results indicate that digital CBT-I provides important benefits for older adults, offering strong potential to expand access to insomnia treatment for this underserved population.
由于一线治疗方法（失眠认知行为疗法，CBT-I）的可及性有限，患有失眠症的老年人在寻求治疗时面临着巨大挑战。本研究在一项三臂随机对照试验（单独使用SHUTi OASIS、SHUTi OASIS+逐步支持、在线患者教育[PE]）中，评估了针对患有失眠症的老年人的定制CBT-I互联网干预措施“老年人失眠和睡眠不足的互联网健康睡眠法（SHUTi OASIS）”的疗效。311名参与者（年龄在55 - 95岁之间）被随机分配接受SHUTi OASIS（单独使用n = 105；联合逐步支持n = 102），与接受PE的参与者（n = 104）相比，这两种情况在治疗后、6个月和12个月随访时的失眠严重程度均有显著改善。接受SHUTi OASIS的参与者在失眠反应和缓解的临床有意义指标方面也更高。在大多数时间点，接受SHUTi OASIS的参与者在包括入睡潜伏期、睡眠中觉醒、睡眠效率、觉醒次数、睡眠质量和疲劳等次要结局方面也显著优于接受PE的参与者。结果表明，数字化CBT-I为老年人带来了重要益处，为扩大这一服务不足人群的失眠治疗可及性提供了强大潜力。
