{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:17:04Z","timestamp":1783772224367,"version":"3.55.0"},"reference-count":101,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["16\/84\/01"],"award-info":[{"award-number":["16\/84\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title>\n<jats:p>Insomnia is a prevalent and distressing sleep disorder. Multicomponent cognitive\u2013behavioural therapy is the recommended first-line treatment, but access remains extremely limited, particularly in primary care where insomnia is managed. One principal component of cognitive\u2013behavioural therapy is a behavioural treatment called sleep restriction therapy, which could potentially be delivered as a brief single-component intervention by generalists in primary care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-2\"><jats:title>Objectives<\/jats:title>\n<jats:p>The primary objective of the Health-professional Administered Brief Insomnia Therapy trial was to establish whether nurse-delivered sleep restriction therapy in primary care improves insomnia relative to sleep hygiene. Secondary objectives were to establish whether nurse-delivered sleep restriction therapy was cost-effective, and to undertake a process evaluation to understand intervention delivery, fidelity and acceptability.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-3\"><jats:title>Design<\/jats:title>\n<jats:p>Pragmatic, multicentre, individually randomised, parallel-group, superiority trial with embedded process evaluation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-4\"><jats:title>Setting<\/jats:title>\n<jats:p>National Health Service general practice in three regions of England.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-5\"><jats:title>Participants<\/jats:title>\n<jats:p>Adults aged \u2265\u200518 years with insomnia disorder were randomised using a validated web-based randomisation programme.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-6\"><jats:title>Interventions<\/jats:title>\n<jats:p>Participants in the intervention group were offered a brief four-session nurse-delivered behavioural treatment involving two in-person sessions and two by phone. Participants were supported to follow a prescribed sleep schedule with the aim of restricting and standardising time in bed. Participants were also provided with a sleep hygiene leaflet. The control group received the same sleep hygiene leaflet by e-mail or post. There was no restriction on usual care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-7\"><jats:title>Main outcome measures<\/jats:title>\n<jats:p>Outcomes were assessed at 3, 6 and 12 months. Participants were included in the primary analysis if they contributed at least one post-randomisation outcome. The primary end point was self-reported insomnia severity with the Insomnia Severity Index at 6 months. Secondary outcomes were health-related and sleep-related quality of life, depressive symptoms, work productivity and activity impairment, self-reported and actigraphy-defined sleep, and hypnotic medication use. Cost-effectiveness was evaluated using the incremental cost per quality-adjusted life-year. For the process evaluation, semistructured interviews were carried out with participants, nurses and practice managers or general practitioners. Due to the nature of the intervention, both participants and nurses were aware of group allocation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-8\"><jats:title>Results<\/jats:title>\n<jats:p>We recruited 642 participants (<jats:italic>n<\/jats:italic>\u2005=\u2005321 for sleep restriction therapy; <jats:italic>n<\/jats:italic>\u2005=\u2005321 for sleep hygiene) between 29 August 2018 and 23 March 2020. Five hundred and eighty participants (90.3%) provided data at a minimum of one follow-up time point; 257 (80.1%) participants in the sleep restriction therapy arm and 291 (90.7%) participants in the sleep hygiene arm provided primary outcome data at 6 months. The estimated adjusted mean difference on the Insomnia Severity Index was \u22123.05 (95% confidence interval \u22123.83 to \u22122.28; <jats:italic>p<\/jats:italic>\u2005&lt;\u20050.001, Cohen\u2019s <jats:italic>d<\/jats:italic>\u2005=\u2005\u22120.74), indicating that participants in the sleep restriction therapy arm [mean (standard deviation) Insomnia Severity Index\u2005=\u200510.9 (5.5)] reported lower insomnia severity compared to sleep hygiene [mean (standard deviation) Insomnia Severity Index\u2005=\u200513.9 (5.2)]. Large treatment effects were also found at 3 (<jats:italic>d<\/jats:italic>\u2005=\u2005\u20130.95) and 12 months (<jats:italic>d<\/jats:italic>\u2005=\u2005\u22120.72). Superiority of sleep restriction therapy over sleep hygiene was evident at 3, 6 and 12 months for self-reported sleep, mental health-related quality of life, depressive symptoms, work productivity impairment and sleep-related quality of life. Eight participants in each group experienced serious adverse events but none were judged to be related to the intervention. The incremental cost per quality-adjusted life-year gained was \u00a32075.71, giving a 95.3% probability that the intervention is cost-effective at a cost-effectiveness threshold of \u00a320,000. The process evaluation found that sleep restriction therapy was acceptable to both nurses and patients, and delivered with high fidelity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-9\"><jats:title>Limitations<\/jats:title>\n<jats:p>While we recruited a clinical sample, 97% were of white ethnic background and 50% had a university degree, which may limit generalisability to the insomnia population in England.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-10\"><jats:title>Conclusions<\/jats:title>\n<jats:p>Brief nurse-delivered sleep restriction therapy in primary care is clinically effective for insomnia disorder, safe, and likely to be cost-effective.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-11\"><jats:title>Future work<\/jats:title>\n<jats:p>Future work should examine the place of sleep restriction therapy in the insomnia treatment pathway, assess generalisability across diverse primary care patients with insomnia, and consider additional methods to enhance patient engagement with treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-12\"><jats:title>Trial registration<\/jats:title>\n<jats:p>This trial is registered as ISRCTN42499563.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-13\"><jats:title>Funding<\/jats:title>\n<jats:p>The award was funded by the National Institute of Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16\/84\/01) and is published in full in <jats:italic>Health Technology Assessment<\/jats:italic>; Vol. 28, No. 36. See the NIHR Funding and Awards website for further award information.<\/jats:p>\n<\/jats:sec>","DOI":"10.3310\/rjyt4275","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T13:03:12Z","timestamp":1724677392000},"page":"1-107","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Nurse-delivered sleep restriction therapy to improve insomnia disorder in primary care: the HABIT RCT"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9581-5311","authenticated-orcid":true,"given":"Simon D","family":"Kyle","sequence":"first","affiliation":[{"name":"Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Dorothy Crowfoot Hodgkin Building, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9558-3349","authenticated-orcid":true,"given":"Peter","family":"Bower","sequence":"additional","affiliation":[{"name":"NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0331-7364","authenticated-orcid":true,"given":"Ly-Mee","family":"Yu","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2484-8201","authenticated-orcid":true,"given":"Aloysius Niroshan","family":"Siriwardena","sequence":"additional","affiliation":[{"name":"School of Health and Social Care, University of Lincoln, Lincoln, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-1685","authenticated-orcid":true,"given":"Yaling","family":"Yang","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-6050","authenticated-orcid":true,"given":"Stavros","family":"Petrou","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7643-572X","authenticated-orcid":true,"given":"Emma","family":"Ogburn","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8628-0319","authenticated-orcid":true,"given":"Nargis","family":"Begum","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-2320","authenticated-orcid":true,"given":"Leonie","family":"Maurer","sequence":"additional","affiliation":[{"name":"Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Dorothy Crowfoot Hodgkin Building, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1721-7682","authenticated-orcid":true,"given":"Barbara","family":"Robinson","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0487-3979","authenticated-orcid":true,"given":"Caroline","family":"Gardner","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-4844","authenticated-orcid":true,"given":"Stephanie","family":"Armstrong","sequence":"additional","affiliation":[{"name":"School of Health and Social Care, University of Lincoln, Lincoln, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-3400","authenticated-orcid":true,"given":"Julie","family":"Pattinson","sequence":"additional","affiliation":[{"name":"School of Health and Social Care, University of Lincoln, Lincoln, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-8734","authenticated-orcid":true,"given":"Colin A","family":"Espie","sequence":"additional","affiliation":[{"name":"Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Dorothy Crowfoot Hodgkin Building, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1802-4217","authenticated-orcid":true,"given":"Paul","family":"Aveyard","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2024,8]]},"reference":[{"key":"key2024082618283400_ref1-bib1","doi-asserted-by":"crossref","first-page":"e036248","DOI":"10.1136\/bmjopen-2019-036248","article-title":"Primary care treatment of insomnia: study protocol for a pragmatic, multicentre, randomised controlled trial comparing nurse-delivered sleep restriction therapy to sleep hygiene (the HABIT trial)","volume":"10","author":"Kyle","year":"2020","journal-title":"BMJ Open"},{"key":"key2024082618283400_ref2-bib2","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/15402002.2010.487450","article-title":"\u2018\u2026 Not just a minor thing, it is something major, which stops you from functioning daily\u2019: quality of life and daytime functioning in insomnia","volume":"8","author":"Kyle","year":"2010","journal-title":"Behav Sleep Med"},{"key":"key2024082618283400_ref3-bib3","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.sleep.2012.10.023","article-title":"The Glasgow Sleep Impact Index (GSII): a novel patient-centred measure for assessing sleep-related quality of life impairment in insomnia disorder","volume":"14","author":"Kyle","year":"2013","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref4-bib4","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/S0140-6736(11)60750-2","article-title":"Chronic insomnia","volume":"379","author":"Morin","year":"2012","journal-title":"Lancet"},{"key":"key2024082618283400_ref5-bib5","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.smrv.2012.09.005","article-title":"Insomnia with objective short sleep duration: the most biologically severe phenotype of the disorder","volume":"17","author":"Vgontzas","year":"2013","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref6-bib6","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.37765\/ajmc.2020.43008","article-title":"Economic burden and managed care considerations for the treatment of insomnia","volume":"26","author":"Taddei-Allen","year":"2020","journal-title":"Am J Manag Care"},{"key":"key2024082618283400_ref7-bib7","doi-asserted-by":"crossref","first-page":"zsz007","DOI":"10.1093\/sleep\/zsz007","article-title":"Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries","volume":"42","author":"Wickwire","year":"2019","journal-title":"Sleep"},{"key":"key2024082618283400_ref8-bib8","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.smrv.2015.11.004","article-title":"Health economics of insomnia treatments: the return on investment for a good night\u2019s sleep","volume":"30","author":"Wickwire","year":"2016","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref9-bib9","first-page":"55","article-title":"The economic burden of insomnia: direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers","volume":"32","author":"Daley","year":"2009","journal-title":"Sleep"},{"key":"key2024082618283400_ref10-bib10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.7326\/M15-2175","article-title":"Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians","volume":"165","author":"Qaseem","year":"2016","journal-title":"Ann Intern Med"},{"key":"key2024082618283400_ref11-bib11","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/jsr.12594","article-title":"European guideline for the diagnosis and treatment of insomnia","volume":"26","author":"Riemann","year":"2017","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref12-bib12","volume-title":"CKS is Only Available in the UK","author":"National Institute for Health and Care Excellence (NICE)"},{"key":"key2024082618283400_ref13-bib13","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1177\/0269881119855343","article-title":"British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update","volume":"33","author":"Wilson","year":"2019","journal-title":"J Psychopharmacol"},{"key":"key2024082618283400_ref14-bib14","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.3399\/bjgp14X677176","article-title":"GPs\u2019 management strategies for patients with insomnia: a survey and qualitative interview study","volume":"64","author":"Everitt","year":"2014","journal-title":"Br J Gen Pract"},{"key":"key2024082618283400_ref15-bib15","doi-asserted-by":"crossref","first-page":"e180","DOI":"10.3399\/bjgp10X484183","article-title":"Patients\u2019 and clinicians\u2019 experiences of consultations in primary care for sleep problems and insomnia: a focus group study","volume":"60","author":"Dyas","year":"2010","journal-title":"Br J Gen Pract"},{"key":"key2024082618283400_ref16-bib16","doi-asserted-by":"crossref","first-page":"e13121","DOI":"10.1111\/jsr.13121","article-title":"Prevalence and management of chronic insomnia in Swiss primary care: cross-sectional data from the \u2018Sentinella\u2019 practice-based research network","volume":"29","author":"Maire","year":"2020","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref17-bib17","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1001\/archinternmed.2010.535","article-title":"Efficacy of brief behavioral treatment for chronic insomnia in older adults","volume":"171","author":"Buysse","year":"2011","journal-title":"Arch Intern Med"},{"key":"key2024082618283400_ref18-bib18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0005-7967(99)00157-6","article-title":"The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice","volume":"39","author":"Espie","year":"2001","journal-title":"Behav Res Ther"},{"key":"key2024082618283400_ref19-bib19","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1093\/sleep\/30.5.574","article-title":"Randomized clinical effectiveness trial of nurse-administered small-group cognitive behavior therapy for persistent insomnia in general practice","volume":"30","author":"Espie","year":"2007","journal-title":"Sleep"},{"key":"key2024082618283400_ref20-bib20","doi-asserted-by":"crossref","first-page":"4651","DOI":"10.1200\/JCO.2007.13.9006","article-title":"Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer","volume":"26","author":"Espie","year":"2008","journal-title":"J Clin Oncol"},{"key":"key2024082618283400_ref21-bib21","first-page":"e59","article-title":"A systematic review of adaptive cognitive behavioral therapy for insomnia implemented in primary care settings","volume":"40","author":"Cheung","year":"2017","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref22-bib22","doi-asserted-by":"crossref","first-page":"e657","DOI":"10.3399\/bjgp19X705065","article-title":"Cognitive behavioural treatment for insomnia in primary care: a systematic review of sleep outcomes","volume":"69","author":"Davidson","year":"2019","journal-title":"Br J Gen Pract"},{"key":"key2024082618283400_ref23-bib23","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.smrv.2018.07.005","article-title":"How does sleep restriction therapy for insomnia work? A systematic review of mechanistic evidence and the introduction of the Triple-R model","volume":"42","author":"Maurer","year":"2018","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref24-bib24","doi-asserted-by":"crossref","first-page":"e13260","DOI":"10.1111\/jsr.13260","article-title":"The acute effects of sleep restriction therapy for insomnia on circadian timing and vigilance","volume":"30","author":"Maurer","year":"2021","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref25-bib25","doi-asserted-by":"crossref","first-page":"zsab223","DOI":"10.1093\/sleep\/zsab223","article-title":"The effect of sleep restriction therapy for insomnia on multidimensional assessments of sleep pressure and arousal: results from a randomised, controlled, mechanistic trial","volume":"45","author":"Maurer","year":"2022","journal-title":"Sleep"},{"key":"key2024082618283400_ref26-bib26","doi-asserted-by":"crossref","first-page":"zsaa096","DOI":"10.1093\/sleep\/zsaa096","article-title":"Isolating the role of time in bed restriction in the treatment of insomnia: a randomized, controlled, dismantling trial comparing sleep restriction therapy with time in bed regularization","volume":"43","author":"Maurer","year":"2020","journal-title":"Sleep"},{"key":"key2024082618283400_ref27-bib27","doi-asserted-by":"crossref","first-page":"101493","DOI":"10.1016\/j.smrv.2021.101493","article-title":"The clinical effects of sleep restriction therapy for insomnia: a meta-analysis of randomised controlled trials","volume":"58","author":"Maurer","year":"2021","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref28-bib28","doi-asserted-by":"crossref","first-page":"e508","DOI":"10.3399\/bjgp15X686137","article-title":"Simplified sleep restriction for insomnia in general practice: a randomised controlled trial","volume":"65","author":"Falloon","year":"2015","journal-title":"Br J Gen Pract"},{"key":"key2024082618283400_ref29-bib29","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.sleep.2011.03.016","article-title":"No pain, no gain: an exploratory within-subjects mixed-methods evaluation of the patient experience of sleep restriction therapy (SRT) for insomnia","volume":"12","author":"Kyle","year":"2011","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref30-bib30","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1111\/j.1467-789X.2012.01029.x","article-title":"Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: a systematic review","volume":"13","author":"Sargent","year":"2012","journal-title":"Obes Rev"},{"key":"key2024082618283400_ref31-bib31","first-page":"923","article-title":"Psychological treatment for insomnia in the management of long-term hypnotic drug use: a pragmatic randomised controlled trial","volume":"53","author":"Morgan","year":"2003","journal-title":"Br J Gen Pract"},{"key":"key2024082618283400_ref32-bib32","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1111\/j.1532-5415.2012.04175.x","article-title":"Self-help treatment for insomnia symptoms associated with chronic conditions in older adults: a randomized controlled trial","volume":"60","author":"Morgan","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"key2024082618283400_ref33-bib33","doi-asserted-by":"crossref","first-page":"101351","DOI":"10.1016\/j.smrv.2020.101351","article-title":"Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review","volume":"54","author":"Natsky","year":"2020","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref34-bib34","doi-asserted-by":"crossref","first-page":"e004183","DOI":"10.1136\/bmjopen-2013-004183","article-title":"The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder","volume":"4","author":"Espie","year":"2014","journal-title":"BMJ Open"},{"key":"key2024082618283400_ref36-bib36","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"key":"key2024082618283400_ref37-bib37","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1177\/0269881110379307","article-title":"British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders","volume":"24","author":"Wilson","year":"2010","journal-title":"J Psychopharmacol"},{"key":"key2024082618283400_ref38-bib38","doi-asserted-by":"crossref","first-page":"263","DOI":"10.5664\/jcsm.8988","article-title":"Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment","volume":"17","author":"Edinger","year":"2021","journal-title":"J Clin Sleep Med"},{"key":"key2024082618283400_ref39-bib39","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1001\/jamapsychiatry.2018.2745","article-title":"Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial","volume":"76","author":"Espie","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"key2024082618283400_ref40-bib40","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref41-bib41","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"key2024082618283400_ref42-bib42","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care"},{"key":"key2024082618283400_ref43-bib43","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"key2024082618283400_ref44-bib44","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2165\/00019053-199304050-00006","article-title":"The validity and reproducibility of a work productivity and activity impairment instrument","volume":"4","author":"Reilly","year":"1993","journal-title":"PharmacoEconomics"},{"key":"key2024082618283400_ref45-bib45","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/0005-7967(85)90004-X","article-title":"The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale","volume":"23","author":"Nicassio","year":"1985","journal-title":"Behav Res Ther"},{"key":"key2024082618283400_ref46-bib46","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1365-2869.2005.00481.x","article-title":"Towards a valid, reliable measure of sleep effort","volume":"14","author":"Broomfield","year":"2005","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref47-bib47","doi-asserted-by":"crossref","first-page":"287","DOI":"10.5665\/sleep.1642","article-title":"The consensus sleep diary: standardizing prospective sleep self-monitoring","volume":"35","author":"Carney","year":"2012","journal-title":"Sleep"},{"key":"key2024082618283400_ref48-bib48","volume-title":"Measuring Mental Health Needs","author":"Beecham","year":"1992"},{"key":"key2024082618283400_ref49-bib49","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-SD: a measure of health status from the EuroQol Group","volume":"33","author":"Rabin","year":"2001","journal-title":"Ann Med"},{"key":"key2024082618283400_ref50-bib50","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0167-6296(01)00130-8","article-title":"The estimation of a preference-based measure of health from the SF-36","volume":"21","author":"Brazier","year":"2002","journal-title":"J Health Econ"},{"key":"key2024082618283400_ref51-bib51","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/0272989X13480428","article-title":"Effect of adding a sleep dimension to the EQ-5D descriptive system: a \u2018bolt-on\u2019 experiment","volume":"34","author":"Yang","year":"2013","journal-title":"Med Decis Making"},{"key":"key2024082618283400_ref52-bib52","first-page":"25","article-title":"Intervention fidelity in primary care complex intervention trials: qualitative study using telephone interviews of patients and practitioners","volume":"22","author":"Dyas","year":"2014","journal-title":"Qual Prim Care"},{"key":"key2024082618283400_ref53-bib53","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How many interviews are enough? An experiment with data saturation and variability","volume":"18","author":"Guest","year":"2006","journal-title":"Field Methods"},{"key":"key2024082618283400_ref54-bib54","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/0191-8869(91)90110-W","article-title":"Horne & \u00d6stberg morningness-eveningness questionnaire: a reduced scale","volume":"12","author":"Adan","year":"1991","journal-title":"Pers Individ Dif"},{"key":"key2024082618283400_ref55-bib55","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1037\/0022-3514.51.6.1173","article-title":"The moderator\u2013mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations","volume":"51","author":"Baron","year":"1986","journal-title":"J Pers Soc Psychol"},{"key":"key2024082618283400_ref56-bib56","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/S2215-0366(17)30328-0","article-title":"The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis","volume":"4","author":"Freeman","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"key2024082618283400_ref57-bib57","doi-asserted-by":"crossref","first-page":"h1258","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","year":"2015","journal-title":"BMJ"},{"key":"key2024082618283400_ref58-bib58","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1136\/jech.53.1.46","article-title":"Assessment of the SF-36 version 2 in the United Kingdom","volume":"53","author":"Jenkinson","year":"1999","journal-title":"J Epidemiol Community Health"},{"key":"key2024082618283400_ref59-bib59","doi-asserted-by":"crossref","first-page":"d1548","DOI":"10.1136\/bmj.d1548","article-title":"Economic evaluation alongside randomised controlled trials: design, conduct, analysis, and reporting","volume":"342","author":"Petrou","year":"2011","journal-title":"BMJ"},{"key":"key2024082618283400_ref60-bib60","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1017\/S0266462313000160","article-title":"Consolidated health economic evaluation reporting standards (cheers) statement","volume":"29","author":"Husereau","year":"2013","journal-title":"Int J Technol Assess Health Care"},{"key":"key2024082618283400_ref61-bib61","volume-title":"Archived Reference Costs","author":"NHS Improvement"},{"key":"key2024082618283400_ref62-bib62","volume-title":"Unit Costs of Health and Social Care 2018. Personal Social Services Research Unit","author":"Curtis"},{"key":"key2024082618283400_ref63-bib63","volume-title":"British National Formulary","author":"National Institute for Health and Care Excellence (NICE)"},{"key":"key2024082618283400_ref64-bib64","volume-title":"Guide to the Methods of Technology Appraisal","author":"National Institute for Health and Care Excellence (NICE)","year":"2013"},{"key":"key2024082618283400_ref65-bib65","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s40273-014-0193-3","article-title":"A guide to handling missing data in cost-effectiveness analysis conducted within randomised controlled trials","volume":"32","author":"Faria","year":"2014","journal-title":"PharmacoEconomics"},{"key":"key2024082618283400_ref66-bib66","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"key2024082618283400_ref67-bib67","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1002\/sim.7654","article-title":"Bootstrap inference when using multiple imputation","volume":"37","author":"Schomaker","year":"2018","journal-title":"Stat Med"},{"key":"key2024082618283400_ref68-bib68","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jad.2020.01.057","article-title":"Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies","volume":"265","author":"Irvine","year":"2020","journal-title":"J Affect Disord"},{"key":"key2024082618283400_ref69-bib69","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/jsr.12024","article-title":"Ecological momentary assessment of daytime symptoms during sleep restriction therapy for insomnia","volume":"22","author":"Miller","year":"2013","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref70-bib70","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5665\/sleep.3386","article-title":"Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder","volume":"37","author":"Kyle","year":"2014","journal-title":"Sleep"},{"key":"key2024082618283400_ref71-bib71","doi-asserted-by":"crossref","first-page":"101208","DOI":"10.1016\/j.smrv.2019.08.002","article-title":"Cognitive behavioral therapy for insomnia: a meta-analysis of long-term effects in controlled studies","volume":"48","author":"van der Zweerde","year":"2019","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref72-bib72","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.smrv.2017.02.001","article-title":"Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis","volume":"38","author":"Van Straten","year":"2018","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref73-bib73","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.smrv.2019.06.002","article-title":"The impact of cognitive behavioural therapy for insomnia on objective sleep parameters: a meta-analysis and systematic review","volume":"47","author":"Mitchell","year":"2019","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref74-bib74","doi-asserted-by":"crossref","first-page":"101873","DOI":"10.1016\/j.cpr.2020.101873","article-title":"The efficacy of cognitive and behavior therapies for insomnia on daytime symptoms: a systematic review and network meta-analysis","volume":"80","author":"Benz","year":"2020","journal-title":"Clin Psychol Rev"},{"key":"key2024082618283400_ref75-bib75","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.sleep.2005.08.008","article-title":"Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors","volume":"7","author":"Morin","year":"2006","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref76-bib76","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.smrv.2018.10.006","article-title":"Insomnia as a predictor of mental disorders: a systematic review and meta-analysis","volume":"43","author":"Hertenstein","year":"2019","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref77-bib77","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1017\/S0033291718004208","article-title":"Cognitive behaviour therapy for depression in primary care: systematic review and meta-analysis","volume":"49","author":"Santoft","year":"2019","journal-title":"Psychol Med"},{"key":"key2024082618283400_ref78-bib78","doi-asserted-by":"crossref","first-page":"101404","DOI":"10.1016\/j.smrv.2020.101404","article-title":"The effect of cognitive behavioural therapy for insomnia on sedative-hypnotic use: a narrative review","volume":"56","author":"Sweetman","year":"2020","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref79-bib79","doi-asserted-by":"crossref","first-page":"101412","DOI":"10.1016\/j.smrv.2020.101412","article-title":"Reporting of adverse events in cognitive behavioural therapy for insomnia: a systematic examination of randomised controlled trials","volume":"56","author":"Condon","year":"2021","journal-title":"Sleep Med Rev"},{"key":"key2024082618283400_ref80-bib80","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.brat.2015.06.001","article-title":"Guided internet cognitive behavioral therapy for insomnia compared to a control treatment \u2013 a randomized trial","volume":"71","author":"Kaldo","year":"2015","journal-title":"Behav Res Ther"},{"key":"key2024082618283400_ref81-bib81","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.sleep.2019.01.045","article-title":"A randomized controlled trial comparing guided internet-based multi-component treatment and internet-based guided sleep restriction treatment to care as usual in insomnia","volume":"62","author":"Krieger","year":"2019","journal-title":"Sleep Med"},{"key":"key2024082618283400_ref82-bib82","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.2196\/jmir.5639","article-title":"Commencing and persisting with a web-based cognitive behavioral intervention for insomnia: a qualitative study of treatment completers","volume":"19","author":"Chan","year":"2017","journal-title":"J Med Internet Res"},{"key":"key2024082618283400_ref83-bib83","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1037\/0022-006X.76.5.820","article-title":"Barriers to engagement in sleep restriction and stimulus control in chronic insomnia","volume":"76","author":"Vincent","year":"2008","journal-title":"J Consult Clin Psychol"},{"key":"key2024082618283400_ref84-bib84","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.bbr.2017.09.016","article-title":"Acute alerting effects of light: a systematic literature review","volume":"337","author":"Souman","year":"2018","journal-title":"Behav Brain Res"},{"key":"key2024082618283400_ref85-bib85","doi-asserted-by":"crossref","first-page":"e16429","DOI":"10.1371\/journal.pone.0016429","article-title":"Non-visual effects of light on melatonin, alertness and cognitive performance: can blue-enriched light keep us alert?","volume":"6","author":"Chellappa","year":"2011","journal-title":"PLOS ONE"},{"key":"key2024082618283400_ref86-bib86","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1093\/sleep\/26.6.695","article-title":"Daytime exposure to bright light, as compared to dim light, decreases sleepiness and improves psychomotor vigilance performance","volume":"26","author":"Phipps-Nelson","year":"2003","journal-title":"Sleep"},{"key":"key2024082618283400_ref87-bib87","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.bbr.2014.12.043","article-title":"Dawn simulation light impacts on different cognitive domains under sleep restriction","volume":"281","author":"Gabel","year":"2015","journal-title":"Behav Brain Res"},{"key":"key2024082618283400_ref88-bib88","doi-asserted-by":"crossref","first-page":"18073","DOI":"10.1038\/s41598-019-54311-x","article-title":"Light therapy with boxes or glasses to counteract effects of acute sleep deprivation","volume":"9","author":"Comtet","year":"2019","journal-title":"Sci Rep"},{"key":"key2024082618283400_ref89-bib89","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s13063-019-3334-3","article-title":"Partner-assisted cognitive behavioural therapy for insomnia versus cognitive behavioural therapy for insomnia: a randomised controlled trial","volume":"20","author":"Mellor","year":"2019","journal-title":"Trials"},{"key":"key2024082618283400_ref90-bib90","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1017\/S0033291715002561","article-title":"Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial","volume":"46","author":"Cape","year":"2016","journal-title":"Psychol Med"},{"key":"key2024082618283400_ref91-bib91","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1016\/S2589-7500(20)30135-7","article-title":"Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial","volume":"2","author":"Vedaa","year":"2020","journal-title":"Lancet Digit Health"},{"key":"key2024082618283400_ref92-bib92","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S2215-0366(15)00536-2","article-title":"Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial","volume":"3","author":"Christensen","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"key2024082618283400_ref93-bib93","doi-asserted-by":"crossref","first-page":"103922","DOI":"10.1016\/j.brat.2021.103922","article-title":"Does adjunctive digital CBT for insomnia improve clinical outcomes in an improving access to psychological therapies service?","volume":"144","author":"Stott","year":"2021","journal-title":"Behav Res Ther"},{"key":"key2024082618283400_ref94-bib94","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1037\/a0036606","article-title":"Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial","volume":"82","author":"Harvey","year":"2014","journal-title":"J Consult Clin Psychol"},{"key":"key2024082618283400_ref95-bib95","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.brat.2014.01.005","article-title":"Psycho-educational CBT-Insomnia workshops in the community. A cost-effectiveness analysis alongside a randomised controlled trial","volume":"55","author":"Bonin","year":"2014","journal-title":"Behav Res Ther"},{"key":"key2024082618283400_ref96-bib96","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1080\/15402002.2021.1901708","article-title":"Cost-effectiveness of guided internet-delivered cognitive behavioral therapy in comparison with care-as-usual for patients with insomnia in general practice","volume":"20","author":"Baka","year":"2021","journal-title":"Behav Sleep Med"},{"key":"key2024082618283400_ref97-bib97","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/jgs.17469","article-title":"Cost-effectiveness of telephone cognitive behavioral therapy for osteoarthritis-related insomnia","volume":"70","author":"Yeung","year":"2022","journal-title":"J Am Geriatr Soc"},{"key":"key2024082618283400_ref98-bib98","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.5665\/sleep.6152","article-title":"Internet-based cognitive behavioral therapy for insomnia: a health economic evaluation","volume":"39","author":"Thiart","year":"2016","journal-title":"Sleep"},{"key":"key2024082618283400_ref99-bib99","doi-asserted-by":"crossref","first-page":"e25609","DOI":"10.2196\/25609","article-title":"Guided internet-based cognitive behavioral therapy for insomnia: health-economic evaluation from the societal and public health care perspective alongside a randomized controlled trial","volume":"23","author":"Buntrock","year":"2021","journal-title":"J Med Internet Res"},{"key":"key2024082618283400_ref100-bib100","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1186\/s13063-020-04613-7","article-title":"Developing a roadmap to improve trial delivery for under-served groups: results from a UK multi-stakeholder process","volume":"21","author":"Witham","year":"2020","journal-title":"Trials"},{"key":"key2024082618283400_ref101-bib101","doi-asserted-by":"crossref","first-page":"e12967","DOI":"10.1111\/jsr.12967","article-title":"The European Academy for Cognitive Behavioural Therapy for Insomnia: an initiative of the European Insomnia Network to promote implementation and dissemination of treatment","volume":"29","author":"Baglioni","year":"2020","journal-title":"J Sleep Res"},{"key":"key2024082618283400_ref102-bib102","doi-asserted-by":"crossref","first-page":"d40","DOI":"10.1136\/bmj.d40","article-title":"Strategy for intention to treat analysis in randomised trial with missing data","volume":"342","author":"White","year":"2011","journal-title":"BMJ"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2045759","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/RJYT4275\/RJYT4275.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2045759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T13:04:03Z","timestamp":1724677443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/RJYT4275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":101,"alternative-id":["10.3310\/RJYT4275"],"URL":"https:\/\/doi.org\/10.3310\/rjyt4275","relation":{},"ISSN":["2046-4924"],"issn-type":[{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"10-2017","name":"contractual_start_date","label":"contractual_start_date","group":{"name":"article_history","label":"Article History"}},{"value":"09-2021","name":"editorial_review_begun","label":"editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"05-2022","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}