Cognitive and Attitudinal Influences on Willingness to Participate in CBT-I
Overview
This study investigates the cognitive and attitudinal factors influencing willingness to enroll in cognitive behavioral therapy for insomnia (CBT-I) among patients at a Chinese sleep clinic. Key findings indicate that perceived need, beliefs about CBT-I effectiveness, and sleep health knowledge are significant predictors of willingness, while depression and insomnia severity inversely affect this willingness.
Background
Cognitive behavioral therapy for insomnia (CBT-I) is recognized as a first-line treatment for insomnia, yet its uptake is limited by various cognitive and attitudinal barriers. This study aims to elucidate the determinants of willingness to engage in sleep improvement programs among patients at risk of sleep disorders.
Data Highlights
Factor
Odds Ratio (OR)
95% Confidence Interval (CI)
p-value
Perceived need
1.20
1.16–1.25
<0.001
CBT-I effectiveness beliefs
1.12
1.08–1.16
<0.001
Sleep health knowledge
1.09
1.05–1.13
<0.001
Anxiety symptoms
1.07
-
0.005
Depression symptoms
0.94
-
<0.001
Insomnia severity
0.93
-
<0.001
Key Findings
52.1% of participants expressed willingness to enroll in CBT-I.
Cognitive-attitudinal factors were significant independent predictors of enrollment willingness.
Perceived need and beliefs about CBT-I effectiveness positively influenced willingness.
Depression and insomnia severity inversely affected willingness to enroll.
Model discrimination for predicting willingness was modest (AUC = 0.543).
Clinical Implications
Healthcare providers should focus on enhancing patients' knowledge about sleep health and the effectiveness of CBT-I to improve enrollment rates. Addressing cognitive and attitudinal barriers may be essential, particularly for patients exhibiting symptoms of depression and insomnia.
Conclusion
Cognitive and attitudinal factors significantly influence patients' willingness to participate in CBT-I, highlighting the need for targeted interventions to improve engagement in sleep improvement programs.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.
