# Provider Supported Self-Help Cognitive Behavioral Therapy for Insomnia (Tele-Self-CBTI)

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

Anticipated Impacts on Veteran’s Healthcare: Insomnia is pervasive among Veterans and is a risk factor for
the most common mental health problems treated in the VA healthcare system, including depression, PTSD,
and suicidality. A provider-supported Self-management strategy for insomnia can bridge the gap between
unavailable resources and high demand for services, and has the potential to improve outcomes across
multiple life domains.
Project Background/Rationale: Cognitive Behavioral Therapy for Insomnia (CBTI) is a multi-component
insomnia intervention that is recommended as the first-line insomnia treatment. Yet, Veteran access to CBTI is
limited by a number of factors, including an inadequate number of trained providers for the high prevalence of
insomnia among Veterans, the inconvenience of weekly treatment offered exclusively in a clinical setting, and
the distance to VA facilities among rural Veterans. Self-management CBTI is effective in treating insomnia
among those without significant medical and mental health co-morbidities, and requires fewer provider
resources. As such, Self-management CBTI is a viable option for increasing Veteran access to CBTI.
Project Objectives: The proposed study will examine two primary research questions, and one exploratory
research question:
1. Does Tele-Self CBTI result in reduced insomnia severity among Veterans with Insomnia Disorder?
Primary Hypothesis: (H1) Relative to Health Education, participants randomized to receive Tele-Self CBTI will
have greater improvements in insomnia severity, as measured by the Insomnia Severity Index (ISI) at 6 weeks.
2. Does Tele-Self CBTI result in improvements in subjectively and objectively assessed sleep, fatigue,
 depression symptoms, and quality of life (QOL)?
Secondary Hypotheses: (H2) Relative to Health Education, participants randomized to receive Tele-Self CBTI
will have greater improvements in subjective sleep (per diary sleep onset latency, wake after sleep onset, and
sleep efficiency), objective sleep (per actigraphy wake after sleep onset, total sleep time, and sleep efficiency),
fatigue, depression symptoms, and QOL at 6 weeks.
3. How do nurses and administrators perceive Tele-Self CBTI in terms of the feasibility and acceptability of
 implementing this intervention in the primary care setting?
No hypotheses are proposed for this exploratory research question.
Project Methods: Study participants (200) will be randomly assigned in equal proportions to either the Tele-
Self CBTI intervention, or to Health Education. A multi-modal assessment strategy will be used to assess
insomnia severity, sleep parameters, fatigue, depression symptoms, and quality of life across 3 time points:
baseline, 6 weeks (primary endpoint), and 6 months. In addition, we will interview nurses and clinic
administrators about Tele-Self CBTI to inform future efforts to implement and disseminate the intervention in
the primary care clinical setting, if Tele-Self CBTI is found to be effecti...

## Key facts

- **NIH application ID:** 10125820
- **Project number:** 5I01HX002350-03
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Christi S Ulmer
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-11-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10125820

## Citation

> US National Institutes of Health, RePORTER application 10125820, Provider Supported Self-Help Cognitive Behavioral Therapy for Insomnia (Tele-Self-CBTI) (5I01HX002350-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10125820. Licensed CC0.

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