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Using Cognitive Behavioral Therapy to Treat Insomnia in Adults

Background: Insomnia is a physically, mentally, and psychologically complicated and distressing medical condition that can affect adults with or without comorbid conditions. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in overcoming insomnia and other comorbid conditions, without ever ingesting a pill. Unfortunately, CBT is underutilized due to the patient educational time requirements; therefore, medication is often prescribed as a first line of treatment for insomnia. Adults suffering from insomnia with or without comorbid conditions such as psychiatric disorders or cancer have benefitted from CBT as opposed to oral medications such as Ambien and therefore, CBT should be the first line treatment of insomnia in the primary care setting. Provider recommendation of CBT to treat insomnia may be increased with the addition of an online interactive CBT program, thereby decreasing the tolerance and addiction to prescribed sleep medications. Purpose: The purpose of this quality intervention project was to improve DNP and Psych NP students’ education about using CBT and SHUTi, an online CBT program to treat insomnia among the adult patient population. Methods: DNP and Psych NP students were asked to complete a pre-test about CBT and SHUTi, watch 2 videos on CBT and SHUTi about treating insomnia, browse the SHUTi demo product, and complete a post-test about these treatments. Students’ knowledge about CBT and SHUTi were evaluated based on answering questions correctly in the post-test versus the pre-test. Results: Of the 18 students surveyed, only 13 completed both the pre and post-tests. The other 5 completed only the pre-test. Results demonstrated that these 13 students who completed both the pre and post tests scored higher about CBT and SHUTi in the post-test versus the pre-test. None of the students in the pre-test had heard about SHUTi, and in the post-test, most of the students stated that they were very likely to use SHUTi for future patients. Additionally, the average score of correct questions among all participants in the post-test was 94% as opposed to 43% in the pre-test, indicating that the 13 students acquired knowledge about CBT and SHUTi to treat insomnia after the intervention. Implications to Practice: This project demonstrates the benefit of teaching nurse practitioner students about SHUTi and CBT as the first line of treatment for insomnia in the adult population. Teaching these students may increase the likelihood that CBT and SHUTi will be recommended to future patients suffering from insomnia. Conclusion: Providing NP students with information about CBT and SHUTi increased their likelihood to recommend CBT and SHUTi for future patients experiencing insomnia.