Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy
Details
Publication Year 2023,Volume 53,Issue #12,Page 5459-5469
Journal Title
Psychological Medicine
Publication Type
Research article
Abstract
BACKGROUND: Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms. METHODS: This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4-12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models. RESULTS: 114 participants (CBT = 39, LDT = 36, TAU = 39; M(age) = 32.20 +/- 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes -2.01 and -1.52 respectively, p < 0.001) from baseline to post-intervention compared to TAU; improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p < 0.001) but not LDT (p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p > 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea; no others reported adverse events. CONCLUSIONS: Therapist-assisted CBT and LDT were feasible during the first postpartum year; data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.
Keywords
Female; Humans; Infant; Adult; *Sleep Initiation and Maintenance Disorders/therapy; Self Report; *Sleep Wake Disorders; Postpartum Period; *Cognitive Behavioral Therapy; Treatment Outcome
Department(s)
Psychosocial Oncology
PubMed ID
36082412
Open Access at Publisher's Site
https://doi.org/10.1017/S0033291722002616
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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