Chronic insomnia is characterized by difficulties initiating or maintaining sleep to such a degree that it causes daytime impairments for a period of 3 months or more ( American Academy of Sleep Medicine, 2014). The disorder typically co-occurs with other sleep related problems, such as insomnia symptoms ( Luyster et al., 2010 Bjorvatn et al., 2015). The severity of OSA is usually characterized with the apnea-hypopnea-index (AHI), in which a higher AHI indicates more severe OSA. Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder characterized by breathing pauses, oxygen desaturation, and arousals during sleep ( American Academy of Sleep Medicine, 2014). The statistically significant improved sleep at follow-up in both groups is most likely explained by the CPAP treatment. No time × condition interaction effects were detected, suggesting that the self-help book did not improve insomnia symptoms more than the sleep hygiene advice.Ĭonclusion: In this randomized controlled trial among patients with OSA and comorbid insomnia who were initiating CPAP treatment, concurrently treating their insomnia with a self-help book did not improve sleep more than sleep hygiene advice. Similarly, the ISI scores were significantly improved in both conditions (sleep hygiene: 17.0 vs. 21.8) and in the self-help book group (26.3 vs. Results: The scores on the BIS improved significantly from pre-treatment to follow-up in the sleep hygiene advice group (26.8 vs. The main outcome measure was insomnia severity assessed with the Bergen Insomnia Scale (BIS) and the Insomnia Severity Index (ISI). The self-help book focused on cognitive behavioral therapy for insomnia. OSA was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor. Methods: In all, 164 patients were included. Objective: To compare the effects of a self-help book for insomnia to that of sleep hygiene advice in a randomized controlled trial with follow-up after about 3 months among patients who were diagnosed with obstructive sleep apnea (OSA) and comorbid chronic insomnia, and who were concurrently initiating treatment with continuous positive airway pressure (CPAP).
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