ICBT provides web-based CBT and sleep hygiene guidance, simulating an ordinary CBT session (counseling) that is typically conducted by the patient and therapist face-to-face. ICBT has gained increasing attention as a possible treatment for improving insomnia, and many studies on ICBT have been conducted. In this study, this exercise was called the Three Good Things (TGT) exercise. It is a simple diary-like exercise that involves listing 3 good things that happened that day and providing a written explanation of why those things happened. A typical method of positive psychology comprises the exercise of writing 3 good things every day before going to bed every night. Positive psychology is based on the idea of nurturing. Positive psychology focuses on positive psychological traits such as happiness, optimism, and satisfaction with life and was developed by Seligman et al of the University of Pennsylvania based on the reflection that traditional psychology was excessively focused on normalizing negative traits such as mental illness. ICBT was paired with a self-help intervention as a form of noninvasive self-medication.
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This study used internet-based CBT (ICBT) without email support to provide sleep hygiene guidance as a trial treatment.
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Sleep hygiene instructions can provide important knowledge about sleep, including how to adjust living conditions so that good-quality sleep can be obtained, and practice measures for maintaining good-quality sleep throughout life. According to the Japanese Society of Sleep Studies guidelines, it is preferable to prioritize CBT over pharmacotherapy for insomnia.ĬBT for insomnia is a treatment that focuses on anxiety and biased thinking about sleep and improves insomnia by reviewing an individual’s lifestyle, existing anxiety and tension, and any thinking related to the maintenance of insomnia. However, the success of pharmacotherapy is limited. Furthermore, it increases the risk of double prescription and overdose and requires long-term treatment. However, pharmacotherapy is associated with side effects such as dependence, tolerance, anterograde amnesia, muscle relaxant effects, carryover effects, and rebound insomnia. In Japan, there are very few medical institutions that can provide CBT, and there are no barriers to prescribing psychotropic drugs outside of psychiatry and psychosomatic medicine. Insomnia practice guidelines in the United States and Australia recommend cognitive behavioral therapy (CBT) as the first choice for the treatment of insomnia. The provision of face-to-face advice paired with an insomnia improvement program delivered as easy-to-use internet-based life guidance will likely reduce medical expenses. However, the evidence base to support the introduction of lifestyle guidance is lacking. įrom the perspective of optimizing medical costs associated with lifestyle-related diseases, such as diabetes, hypertension, and hyperlipidemia, lifestyle guidance is increasingly being introduced as a complement to the use of medication. In Japan, the economic losses caused by sleep deprivation and insomnia have been estimated to be 15 trillion yen (US $8.67 billion). Another study found that 1 in 5 Japanese adults had sleep problems. It has been reported that 14.9% of people in Japan have profound daytime sleepiness. Insomnia is a common complaint in adults, with 13.5% to 20.6% of the general population experiencing daytime sleepiness > 3 times per week. Insomnia impairs daytime activity and triggers additional illnesses such as depression, lifestyle-related diseases, and cancer. Insomnia can be caused by a variety of factors, including changes in social life such as decreased interpersonal interaction and socializing, as well as mental and physical illnesses, decreased physical function, and physiological changes in the brain. This condition reduces an individual’s quality of life by causing various daytime dysfunctions, including sleepiness during the day. Insomnia describes the inability to sleep, including difficulty falling asleep, difficulty staying asleep, difficulty sleeping, and early waking, despite an attempt to sleep at the right time and in the right environment.
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