To examine determinants of willingness to enroll in sleep improvement programs among adults at risk of sleep disorders attending a tertiary sleep clinic in China.
Approach:
Key Findings:
52.1% of participants expressed willingness to enroll in a structured sleep improvement program.
Cognitive-attitudinal factors such as perceived need (OR = 1.20), beliefs about CBT-I effectiveness (OR = 1.12), and sleep health knowledge (OR = 1.09) positively predicted willingness.
Depression symptoms (OR = 0.94) and insomnia severity (OR = 0.93) inversely predicted willingness to enroll.
Interpretation:
Cognitive-attitudinal factors were significant predictors of enrollment willingness, while demographics and practical barriers did not show independent associations.
Limitations:
Poor model discrimination (AUC = 0.543) limits the conclusions regarding the predictors of willingness.
The study measured stated willingness rather than actual enrollment, which may not reflect true participation.
Conclusion:
Cognitive-attitudinal factors influence willingness to enroll in CBT-I, highlighting the need for prospective validation and motivational enhancement strategies for patients with depression.
