Health professional Administered Brief Insomnia Therapy (HABIT) Trial
The HABIT study aims to look at Cognitive Behavioural Therapy as treatment to Insomnia. Nurse-delivered Sleep Restriction Therapy (alongside Sleep Hygiene) will be compared to Sleep Hygiene alone. This will allow the researchers to establish the clinical and cost effectiveness of Sleep Restriction Therapy.
The study aims to recruit 588 participants across three regions: Thames Valley, Lincolnshire and Manchester. The study will be run by the University of Oxford, with the University of Manchester and University of Lincoln coordinating their regions.
Insomnia is characterised by problems with starting and/or maintaining sleep. This can have an affect on the quality of life for those with insomnia. 10-12% of adults in Europe are affected by insomnia. There are also associated costs with insomnia, including increased healthcare use, reduced productivity and accidents.
This expensive and burdensome condition is treatable but access to evidence-based intervention (Cognitive Behavioural Therapy; CBT) is almost non-existent. In the absence of available treatment, GPs are limited to administering sleep hygiene guidelines, hypnotics, and (off-label) sedative antidepressants; yet none of these are evidence based for persistent insomnia and hypnotics have well-defined side-effects. UK healthcare requires a scalable and cost-effective model to address unmet need. Barriers to wide-scale adoption of CBT for insomnia in the NHS - and worldwide - relate to limited training, expertise and funding.
A major development in the insomnia field, therefore, has been the dismantling of multicomponent CBT into focussed, condensed treatment sessions, and the training of non-experts to deliver such therapies. Sleep Restriction Therapy (SRT) has emerged as one of the primary active ingredients within multi-component CBT and because of its focus on behaviour change, coupled with structured and prescriptive delivery, it is ideally suited for primary care delivery.
SRT involves restricting and standardizing a patient’s time in bed with the aim of increasing homoeostatic sleep pressure, over-riding cognitive and physiological arousal, and strengthening circadian control of sleep. Evidence has shown that tailored prescription of bed and rise-times over several weeks leads to reduced sleep variability and improved sleep consolidation and quality.
Parallel, open-label, randomised-controlled trial
University of Oxford
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Dr Simon Kyle