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Session Schedule

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0:00:00
NEW SLEEP: Using accurate and daily sleep feedback in home environments in order to improve sleep
Manuel Schabus (Austria)

Recording not available: Acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: Outcomes from a RCT and predictors of treatment response
Renatha El-Rafihi Ferreira (Brazil)

0:36:05
Addressing non-response and improving implementation as primary challenges for the future of psychotherapy for insomnia
Elisabeth Hertenstein (Switzerland)

1:03:10
Implementing CBT-I in routine clinical care using a stepped care model: A randomized controlled trial
Kai Spiegelhalder (Germany)

1:22:35
Question and answer

Summary

Insomnia disorder is affecting 10% of the general population and is associated with severe impairments of quality of life and productivity. According to current guidelines, cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for patients with chronic insomnia disorder. In this symposium, we argue that innovation is still much needed to be able to provide optimal care. The authors of this symposium proposal have identified three major challenges at hand, namely optimizing efficacy of the current CBT-I protocol, addressing non-response to CBT-I, and promoting implementation of optimal care into clinical practice.
Efficacy of CBT-I may be optimized with the help of add-ons such as specific wearables and sensors. Manuel Schabus from the University of Salzburg (Austria) will present efficacy and challenges of CBT-I delivered through a smartphone application, enhanced through i) objective measurements and ii) tailored sleep feedback using ambulatory heart rate measures (verified against polysomnography).
Renatha El-Rafihi Ferreira from the University of Sao Paulo (Brazil) and Elisabeth Hertenstein from the University of Geneva (Switzerland) will present two recent randomized-controlled trials on Acceptance and Commitment Therapy for insomnia (ACT-I), a promising candidate for a second-line treatment for non-responders to CBT-I. ACT-I is a psychotherapy with treatment mechanisms different from classic CBT-I, that may be effective for a different patient group in the sense of differential efficacy. In her talk, Renatha El Rafihi-Ferreira will present the results of a randomized controlled trial comparing the effectiveness of ACT-I versus CBT-I versus waiting list. Renatha will also present the effect of ACT-I on depressive symptoms and the predictors of response to the two treatments. In her talk, Elisabeth Hertenstein will focus on a second randomized controlled trial on ACT-I, as well as a recent trial investigating the non-inferiority of bedtime-restriction as a stand-alone treatment compared to full CBT-I. Bedtime restriction as a stand-alone is a brief treatment that may be easier to implement than current protocols.
In his talk, Kai Spiegelhalder from the University Hospital of Freiburg (Germany) will focus on promising strategies that may help overcome the challenge of implementation: internet-delivered CBT-I as a less resource-intensive alternative to face-to-face treatment and a stepped-care model with different versions of CBT-I differing in their amount of therapist support.

Learning Objectives:

Upon completion of this CME activity, participants will be able to:
• Recognize how psychotherapy may be enhanced with the help of objective sleep feedback, and discuss important challenges and pitfalls of this approach
• Describe what Acceptance and Commitment Therapy is, how it works for patients with insomnia, and name predictors of response to Cognitive Behavioral Therapy versus Acceptance and Commitment Therapy
• Identify how Acceptance and Commitment Therapy may address the problem of non-response to CBT-I, and learn about bedtime restriction as a potential easy-to-implement stand-alone treatment
• Report how internet-based therapy for insomnia may be promising to overcome the implementation crisis, and be able to explain a stepped-care model for insomnia care