title: Differential effects of online insomnia treatment on executive functions in adolescents.
abstract: OBJECTIVE
  To examine the effects of online Cognitive Behavior Therapy for Insomnia (CBTI) on adolescents' sleep and cognitive functioning.
  
  
  METHODS
  32 adolescents (13-19 years, M = 15.9, SD = 1.6) with DSM-5 insomnia disorder, were randomly assigned to a treatment group (n = 18) or a waiting list (n = 14). Treatment consisted of six guided self-help online CBTI sessions. Both groups were assessed at baseline and post-treatment. Sleep was measured with actigraphy, sleep logs, and questionnaires. Cognitive functioning was assessed with a battery of standard cognitive tests.
  
  
  RESULTS
  After CBTI the treatment group showed significant improvements compared to the waiting list group in sleep efficiency from actigraphy and sleep logs. This finding was confirmed by improvements in other sleep variables from sleep logs, and in symptoms of chronic sleep reduction and insomnia. Most participants from the treatment group improved to sub clinical levels of insomnia. Cognitive functioning of the treatment group showed more improvement compared to the waiting list in visuospatial processing, selective attention and phonological working memory, and a trend of improvement in response inhibition and set shifting, letter fluency and sustained attention, but not in declarative memory, visuospatial working memory, category fluency, and general cognitive speed. Changes in sleep appeared to be related to changes in cognitive functioning.
  
  
  CONCLUSIONS
  These results indicate that CBTI can have positive effects on cognitive functions in adolescents, with notable improvements in visuospatial processing and phonological working memory but not in visuospatial working memory.
authors: Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam GE 1090, Netherlands. Electronic address: E.J.deBruin@UvA.nl.
authors: Eduard J
authors: EJ
authors: de Bruin
authors: Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam GE 1090, Netherlands.
authors: Julia F
authors: JF
authors: Dewald-Kaufmann
authors: Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam GE 1090, Netherlands.
authors: Frans J
authors: FJ
authors: Oort
authors: Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam GE 1090, Netherlands.
authors: Susan M
authors: SM
authors: Bögels
authors: Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam GE 1090, Netherlands.
authors: Anne Marie
authors: AM
authors: Meijer
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted; D055815:Young Adult
keywords: Adolescents; Cognitive behavior therapy; Cognitive functioning; Ehealth; Insomnia; Internet treatment