Date of Graduation

5-2024

Document Type

Thesis

Degree Name

Master of Arts in Psychology (MA)

Degree Level

Graduate

Department

Psychological Science

Advisor/Mentor

Ivan Vargas

Committee Member

Jessica Fugitt

Second Committee Member

Ellen W. Leen-Feldner

Keywords

College Students; Insomnia; Intervention; Mobile Application; Sleep

Abstract

Previous studies have found that the prevalence of insomnia among college students is high. This has implications for students mental and physical well-being, academic performance, and the onset of more chronic insomnia symptomology. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the front-line treatment for insomnia, but cost and time are often barriers to treatment access. The goal of this study was to test the feasibility, acceptability, and efficacy of a more cost-effective self-guided version of CBT-I (via mobile application). Fifty-five college students, who were mostly women (82%) and mean age 19.3 (SD = 2.3) years with moderate insomnia symptoms were randomized to CBT-I Coach (n = 27) or a wait-list control condition (n = 28) for 8 weeks. Participants in both groups completed self-report measures biweekly across the 8-week study period. Findings suggest that CBT-I Coach is feasible. Participants reported using the app for an average of 5 days a week. More than half of the sample utilized the learning materials, and more than one-third of the sample made use of the tools section. For acceptability, nearly 70% of the participants found the app moderately to extremely effective. Further analyses found that the self-guided mobile intervention was efficacious. The intervention group experienced a larger reduction in insomnia symptoms from baseline to week 4 than the waitlist control group (g = 0.88, p < 0.001). The intervention group did experience a slight rebound at week 8 while the waitlist group reported further symptom reduction. However, the difference in change scores between the groups at post-treatment was not significant (p = 0.43). Additional treatment effects were seen from week 4 to week 8 for depression symptoms (g = 0.94, p = 0.004). These findings provide preliminary evidence that utilizing a self-guided mobile intervention for insomnia among college students is feasible, acceptable, and effective for improving moderate insomnia symptoms. CBT-I Coach and other self-guided app-based versions of CBT-I may increase the dissemination of behavioral sleep interventions for populations who often lack access to behavioral sleep medicine providers or find their insomnia symptoms not being addressed by other healthcare professionals.

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