The efficacy of internet-based cognitive behavior therapy on blood pressure for comorbid hypertension and insomnia

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia. Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected, and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53). All the patients accepted relevant treatment for 8 consecutive weeks. Changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up. Results Compared with pre-treatment, SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P<0.01), the decrease was more significant in CBT-I group than in regular treatment group (P<0.01). The sleep latency, sleep efficiency, bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49±22.75min vs. 55.50±34.96min; 72.31%±9.15% vs. 57.70%±11.53%; 302.65±43.76min vs. 262.70±50.64min and 17.14±6.45 vs. 21.02±6.64, respectively), the differences were of statistical significance (P<0.05). In addition, no significant difference was found in the level of depression between CBT-I group and regular treatment group. Conclusion CBT-I can effectively shorten sleep latency, improve sleep efficiency, extend bed time and improve anxiety, meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality. DOI: 10.11855/j.issn.0577-7402.2017.04.11