Share This Article:

Cognitive Behavioral Therapy as the Basis for Preventive Intervention in a Sleep Health Program: A Quasi-Experimental Study of E-Mail Newsletters to College Students

Abstract Full-Text HTML XML Download Download as PDF (Size:2601KB) PP. 9-16
DOI: 10.4236/ojmp.2015.41002    4,689 Downloads   5,475 Views   Citations

ABSTRACT

Several reports suggest that college students often have atypical sleep patterns and experience poor sleep quality. We examined the effect of a cognitive behavioral therapy (CBT) based intervention program to improve sleep quality and overall mental health among college students. The intervention was delivered in the form of e-mail newsletters. Fifty-three students participated in the intervention group, and another 50 students participated in the control group. The intervention group received a lecture on sleep hygiene; once-weekly e-mail newsletters on sleep health topics (sleep hygiene, stimulus control, sleep restriction, sleep titration, and relapse prevention) and were asked to maintain a four-week sleep diary. The Pittsburgh Sleep Quality Index (PSQI), a measure of sleep quality, and the Kessler 6, a measure of psychological distress, were administered before the lecture (as the baseline measurement) and again 16 weeks later (follow-up measurement). PSQI and K6 scores were reduced in the intervention group compared with the control group. A CBT-based sleep health program utilizing e-mail newsletters may work to improve sleep quality and mental health. This program may represent a cost effective way for Japanese students to receive treatment for poor sleep and may also serve to prevent psychiatric problems.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Asano, K. , Ishimura, I. , Abe, H. , Nakazato, M. , Nakagawa, A. and Shimizu, E. (2015) Cognitive Behavioral Therapy as the Basis for Preventive Intervention in a Sleep Health Program: A Quasi-Experimental Study of E-Mail Newsletters to College Students. Open Journal of Medical Psychology, 4, 9-16. doi: 10.4236/ojmp.2015.41002.

References

[1] Curcio, G., Ferrara, M. and De Gennaro, L. (2006) Sleep Loss, Learning Capacity and Academic Performance. Sleep Medicine Reviews, 10, 323-337.
http://dx.doi.org/10.1016/j.smrv.2005.11.001
[2] Giri, P., Baviskar, M. and Phalke, D. (2013) Study of Sleep Habits and Sleep Problems among Medical Students of Pravara Institute of Medical Sciences Loni, Western maharashtra, India. Annals of Medical and Health Sciences Research, 3, 51-54.
http://dx.doi.org/10.4103/2141-9248.109488
[3] Kwan, M.Y., Faulkner, G.E., Arbour-Nicitopoulos, K.P., et al. (2013) Prevalence of Health-Risk Behaviours among Canadian Post-Secondary Students: Descriptive Results from the National College Health Assessment. BMC Public Health, 13, 548.
http://dx.doi.org/10.1186/1471-2458-13-548
[4] Thomée, S., Harenstam, A. and Hagberg, M. (2012) Computer Use and Stress, Sleep Disturbances, and Symptoms of Depression among Young Adults—A Prospective Cohort Study. BMC Psychiatry, 12, 176.
http://dx.doi.org/10.1186/1471-244X-12-176
[5] Perez-Chada, D., Perez-Lloret, S., Videla, A.J., et al. (2007) Sleep Disordered Breathing and Daytime Sleepiness Are Associated with Poor Academic Performance in Teenagers. A Study Using the Pediatric Daytime Sleepiness Scale (PDSS). Sleep, 30, 1698-1703.
[6] Lund, H.G., Reider, B.D., Whiting, A.B., et al. (2010) Sleep Patterns and Predictors of Disturbed Sleep in a Large Population of College Students. The Journal of Adolescent Health, 46, 124-132.
http://dx.doi.org/10.1016/j.jadohealth.2009.06.016
[7] Taylor, D.J., Bramoweth, A.D., Grieser, E.A., et al. (2013) Epidemiology of Insomnia in College Students: Relationship with Mental Health, Quality of Life, and Substance Use Difficulties. Behavior Therapy, 44, 339-348.
http://dx.doi.org/10.1016/j.beth.2012.12.001
[8] Lopresti, A.L., Hood, S.D. and Drummond, P.D. (2013) A Review of Lifestyle Factors That Contribute to Important Pathways Associated with Major Depression: Diet, Sleep and Exercise. Journal of Affective Disorders, 148, 12-27.
http://dx.doi.org/10.1016/j.jad.2013.01.014
[9] Nyer, M., Farabaugh, A. and Fehling, K., et al. (2013) Relationship between Sleep Disturbance and Depression, Anxiety, and Functioning in College Students. Depression and Anxiety, 30, 873-880.
http://dx.doi.org/10.1002/da.22064
[10] Edinger, J.D. and Means, M.K. (2005) Cognitive-Behavioral Therapy for Primary Insomnia. Clinical Psychology Review, 25, 539-558.
http://dx.doi.org/10.1016/j.cpr.2005.04.003
[11] Morin, C.M., Bootzin, R.R., Buysse, D.J., Edinger, J.D., Espie, C.A. and Lichstein, K.L. (2006) Psychological and Behavioral Treatment of Insomnia: Update of the Recent Evidence (1998-2004). Sleep, 29, 1398-1414.
[12] Sivertsen, B., Omvik, S., Pallesen, S., Bjorvatn, B., Havik, O.E., Kvale, G., et al. (2006) Cognitive Behavioral Therapy vs. Zopiclone for Treatment of Chronic Primary Insomnia in Older Adults: A Randomized Controlled Trial. Journal of the American Medical Association, 295, 2851-2858.
http://dx.doi.org/10.1001/jama.295.24.2851
[13] Watanabe, N., Furukawa, T.A., Shimodera, S., Morokuma, I., Katsuki, F., Fujita, H., et al. (2011) Brief Behavioral Therapy for Refractory Insomnia in Residual Depression: An Assessor-Blind, Randomized Controlled Trial. The Journal of Clinical Psychiatry, 72, 1651-1658.
http://dx.doi.org/10.4088/JCP.10m06130gry
[14] Perils, M.L. and Smith, M.T. (2008) How Can We Make CBT-I and Other BSM Services Widely Available? Journal of Clinical Sleep Medicine, 4, 11-13.
[15] Unbehaun, T., Spiegelhalder, K., Hirscher, V. and Riemann, D. (2010) Management of Insomnia: Update and New Approaches. Nature and Science of Sleep, 2, 127-138.
[16] Strom, L., Pettersson, R. and Andersson, G. (2004) Internet-Based Treatment for Insomnia: A Controlled Evaluation. Journal of Consulting and Clinical Psychology, 72, 113-120.
http://dx.doi.org/10.1037/0022-006X.72.1.113
[17] Ritterband, L.M., Thorndike, F.P., Gonder-Frederick, L.A., Magee, J.C., Bailey, E.T., Saylor, D.K. and Morin, C.M. (2009) Efficacy of an Internet-Based Behavioral Intervention for Adults with Insomnia. Archives of General Psychiatry, 66, 692-698.
http://dx.doi.org/10.1001/archgenpsychiatry.2009.66
[18] Espie, C.A., Kyle, S.D., Williams, C., Ong, J.C., Douglas, N.J., Hames, P. and Brown, J.S. (2012) A Randomized, Placebo-Controlled Trial of Online Cognitive Behavioral Therapy for Chronic Insomnia Disorder Delivered via an Automated Media-Rich Web Application. Sleep, 35, 769-781.
[19] Lancee, J., van den Bout, J. and van Straten, A. and Spoormaker, V.I. (2012) Internet-Delivered or Mailed Self-Help Treatment for Insomnia? A Randomized Waiting-List Controlled Trial. Behaviour Research and Therapy, 50, 22-29.
http://dx.doi.org/10.1016/j.brat.2011.09.012
[20] Brown, F.C., Buboltz, W.C. and Soper, B. (2002) Relationship of Sleep Hygiene Awareness, Sleep Hygiene Practices, and Sleep Quality in University Students. Behavioral Medicine, 28, 33-38.
http://dx.doi.org/10.1080/08964280209596396
[21] Brown, F.C., Buboltz, W.C. and Soper, B. (2006) Development and Evaluation of the Sleep Treatment and Education Program for Students (STEPS). Journal of American College Health, 54, 231-237.
http://dx.doi.org/10.3200/JACH.54.4.231-237
[22] Quan, S.F., Anderson, J.L. and Hodge, G.K. (2013) Use of a Supplementary Internet Based Education Program Improves Sleep Literacy in College Psychology Students. Journal of Clinical Sleep Medicine, 9, 155-160.
[23] Trockel, M., Manber, R., Chang, V., Thurston, A. and Taylor, C.B. (2011) An E-Mail Delivered CBT for Sleep-Health Program for College Students: Effects on Sleep Quality and Depression Symptoms. Journal of Clinical Sleep Medicine, 7, 276-281.
[24] Bjorvatn, B., Fiske, E. and Pallesen, S. (2011) A Self-Help Book Is Better Than Sleep Hygiene Advice for Insomnia: A Randomized Controlled Comparative Study. Scandinavian Journal of Psychology, 52, 580-585.
http://dx.doi.org/10.1111/j.1467-9450.2011.00902.x
[25] Faul, F., Erdfelder, E., Lang, A.G. and Buchner, A. (2007) G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences. Behavior Research Methods, 39, 175-191.
http://dx.doi.org/10.3758/BF03193146
[26] Buysse, D.J., Reynolds, C.F., Monk, T.H., Berman, S.R. and Kupfer, D.J. (1989) The Pittsburgh Sleep Quality Index: A New Instrument for Psychiatric Practice and Research. Psychiatry Research, 28, 193-213.
http://dx.doi.org/10.1016/0165-1781(89)90047-4
[27] Doi, Y., Minowa, M., Uchiyama, M., Okawa, M., Kim, K., Shibui, K. and Kamei, Y. (2000) Psychometric Assessment of Subjective Sleep Quality Using the Japanese Version of the Pittsburgh Sleep Quality Index (PSQI-J) in Psychiatric Disordered and Control Subjects. Psychiatry Research, 97, 165-172.
http://dx.doi.org/10.1016/S0165-1781(00)00232-8
[28] Kessler, R.C., Andrews, G., Colpe, L.J., Hiripi, E., Mroczek, D.K., Normand, S.L., et al. (2002) Short Screening Scales to Monitor Population Prevalences and Trends in Non-Specific Psychological Distress. Psychological Medicine, 32, 959-976.
http://dx.doi.org/10.1017/S0033291702006074
[29] Furukawa, T.A., Kessler, R.C., Slade, T. and Andrews, G. (2003) The Performance of the K6 and K10 Screening Scales for Psychological Distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 33, 357-362.
http://dx.doi.org/10.1017/S0033291702006700
[30] Kanda, Y. (2013) Investigation of the Freely Available Easy-to-Use Software “EZR” for Medical Statistics. Bone Marrow Transplantation, 48, 452-458.
http://dx.doi.org/10.1038/bmt.2012.244
[31] Espie, C.A. (2009) “Stepped Care”: A Health Technology Solution for Delivering Cognitive Behavioral Therapy as a First Line Insomnia Treatment. Sleep, 32, 1549-1558.
[32] Bower, P. and Gilbody, S. (2005) Stepped Care in Psychological Therapies: Access, Effectiveness and Efficiency— Narrative Literature Review. British Journal of Psychiatry, 186, 11-17.
http://dx.doi.org/10.1192/bjp.186.1.11
[33] Chen, L., Wang, L., Qiu, X.H., Yang, X.X., Qiao, Z.X., Yang, Y.J. and Liang, Y. (2013) Depression among Chinese University Students: Prevalence and Socio-Demographic Correlates. PloS ONE, 8, e58379.
http://dx.doi.org/10.1371/journal.pone.0058379
[34] Eisenberg, D., Gollust, S.E., Golberstein, E. and Hefner, J.L. (2007) Prevalence and Correlates of Depression, Anxiety, and Suicidality among University Students. The American Journal of Orthopsychiatry, 77, 534-542.
http://dx.doi.org/10.1037/0002-9432.77.4.534

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.