0473 The impact on treatment adherence of adding a bedpartner to CBT-I: preliminary findings from a randomised controlled trial (Project REST)

Abstract Introduction Cognitive Behavioural Therapy for Insomnia (CBT-I) includes often difficult-to-implement behavioural change, and this can result in poor adherence to treatment recommendations. In other CBTs, adding a significant “individual” therapy increases adherence. Here, we report preliminary findings from randomised controlled trial (RCT) of newly developed partner-assisted CBT-I. Methods 117 adults with DSM-5 Disorder (age M±SD=47.9±15.3yrs; 73F) their live-in partners participated single-blind parallel RCT. They were assigned 1:1:1 7wk individual CBT-I (Ind-CBTI), (PA-CBTI), or sleep management control (CTRL) conditions. Participants completed daily diary throughout the intervention. Adherence conditions was assessed Sleep Restriction (deviation bed wake times, naps) Stimulus Control (wake time-in-bed during daytime, overnight, after final morning awakening). Intention-to-treat, mixed effects models examined differences “Build” (initial phase build debt) “Maintain” (starting first week when opportunity titrated upwards) stages therapy. Results All showed increase efficiency (p<.001), significantly faster Ind-CBTI PA-CBTI compared CTRL (ps<.001). Therapy: Build stage (vs Maintain) had greater prescribed time (p=.045); Condition by Stage interaction (p=.010) Ind-CBTI) adhered better avoiding naps Maintain). daytime (p=.017), especially (interaction p=.071); (p=.017) overnight Maintain Build). Both awakening Build) Conclusion multiple indicators showing distinct features as intervention progresses across different stages. Aspects appear modifiable, bedpartners improved specific aspects (i.e., naps, time-in-bed, time-in-bed). The be associated (Sleep Therapy, respectively). Support (If Any) NHMRC grant APP1105458 (SPAD,DHB,PJN), APP1140299 (BB)Trial registration: ACTRN12616000586415