講師資料
Talks：
The effect of Cognitive Behavioural Therapy for insomnia (CBTi) on patterns of sedative-hypnotic use.
Name：
Dr. Alexander Sweetman
Position：
Senior Program Manager
Affiliation：
1. Australasian Sleep Association
2. Flinders University
Email：
Photo：
Research Interests：
I am interested in the co-morbidity of insomnia and obstructive sleep apnea (COMISA), treating insomnia with Cognitive Behavioural Therapy for insomnia (CBTi), and implementing evidence-based management approaches for sleep disorders throughout the health system.
Selected Publications：
1. Sweetman A, Lack L, … McEvoy D. (2016). Developing a Successful Treatment for Co-morbid Insomnia and Sleep Apnea. Sleep Medicine Reviews. https://doi.org/10.1016/j.smrv.2016.04.004.
2. Sweetman A, Lack L, … McEvoy D. (2019) Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea patients with co-morbid insomnia: A randomized clinical trial. Sleep. 42(12). https://doi.org/10.1093/sleep/zsz178.
3. Sweetman A, Farrell S, Wallace D, Crawford M. (2023). The effect of cognitive behavioural therapy for insomnia in people with co-morbid insomnia and sleep apnoea: A systematic review and meta-analysis. J Sleep Res. https://doi.org/10.1111/jsr.13847.
4. Sweetman A, Reynolds C, … Richardson C. (2023). Effect of high-risk sleep apnoea on treatment-response to a tailored digital cognitive behavioural therapy for insomnia: A quasi-experimental trial. Frontiers in Sleep. https://doi.org/10.3389/frsle.2024.1355468.
5. Sweetman, A., Putland, S., Lack, L., McEvoy, R. D., Adams, R., Grunstein, R., ... & Lovato, N. (2021). The effect of cognitive behavioural therapy for insomnia on sedative-hypnotic use: A narrative review. Sleep medicine reviews, 56. https://doi.org/10.1016/j.smrv.2020.101404.
Abstract：
Introduction: Insomnia is a prevalent condition worldwide. Evidence-based guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the 'first line' treatment, however many patients are managed with sedative-hypnotic medicines. CBTi delivered in primary care may facilitate reduction in sleep medicine use for insomnia through preventing incident sleep medicine prescriptions, and reducing prevalent sleep medicine use.

Methods: A randomised controlled implementation trial is currently being conducted to investigate the effect of an evidence-based digital CBTi program, versus digital sleep education (control) in Australian primary care. 500 patients will be referred to the trial by participating general practitioners. Patients will be randomised 1:1 to CBTi versus control. Self-report symptoms of insomnia, daytime function, mental health, and sleep medicine use will be assessed at baseline and 8-week follow-up.

Results: As of August, 2024, 190 general practitioners have referred 429 patients to the trial. Of the 216 patients that have completed online consent and screening forms, 171 (79.2%) are eligible and have been randomised to CBTi (N=95) or control (N=73). The 20.8% of ineligible patients have been provided recommendations for local ‘sleep’ psychologists. Recruited patients are middle aged (M Age=54.1, sd=15.6), predominantly female (74.3%), and 54% reporting sleep medicine use at baseline.

Discussion: Results from the fully powered study are pending, however promising rates of uptake by general practitioners and patients demonstrates the acceptability and feasibility of embedding a digital CBTi pathway in primary care. Digital CBTi may facilitate improvements in insomnia, daytime function, mental health, and reduced sleep medicine use in primary care.
2024年會：
10/12 14:10 The effect of Cognitive Behavioural Therapy for insomnia (CBTi) on patterns of sedative-hypnotic use. [會議室2]