Insomnia is a common sleep disorder which has a 5–6% prevalence rate and shows high social impact. At least 10% of patients with insomnia will see a medical specialist. Hence, 20,000–40,000 people in Georgia require medical help for insomnia. Treatment of insomnia is very effective. Pharmacotherapy is common, but it is recognized that cognitive behavioral therapy (CBT) is a better choice, since it is safe for patients and shows sustainable improvement. CBT of insomnia is not currently available in Georgia. The aim of our study was to evaluate a Georgian version of an innovative, internet-delivered digital CBT (dCBT) for insomnia in terms of therapeutic efficacy, adherence, and ease of handling. The Georgian digital cognitive behavioral therapy for insomnia was developed as an analogue of Dutch dCBT “i-Sleep.” All online materials were made applicable for the Georgian population through translation, validation by translation back to the original language, and adaptation to the Georgian reality, in order to avoid linguistic, cultural, and social pitfalls. Fifty-two adult patients with insomnia were recruited for the study: 34 women and 18 men, aged 18–64 years (mean: 33.5 years). Inclusion criteria included: age over 18, access to internet, and sufficient skills to use electronic devices. The patients who were treated pharmacologically continued their usual medication and received dCBT in addition to this treatment. DCBT was guided by a therapist. Clinical efficacy was evaluated on the basis of Insomnia Severity Index (ISI), measured before the dCBT and one month after its completion. 25 out of 52 patients (48%) completed a full dCBT course. Mean ISI in this group dropped from 22.88 to 8.24 (P < 0.01), showing significant therapeutic effect one month after CBT completion. 27 patients (52%) stopped treatment for various reasons at different stages of dCBT. Sixteen patients dropped out from the first module (31%). 7 patients older than 50 years encountered problems with handling electronic devices and the platform itself. 9 patients stopped therapy, showing bad adherence for different reasons, mostly related to finding the sessions time-consuming and being disappointed by the absence of immediate therapeutic effect. Eleven more patients (21%) stopped at sleep restriction, finding it difficult to accomplish sleep restriction-related tasks. In general, patients found dCBT quite comprehensive and easy to handle. This data suggests that the Georgian version of dCBT for insomnia is a promising therapeutic tool, comparable with international analogues in terms of efficacy and adherence. Further studies, involving a greater number of patients and long-term follow-up are required for the final assessment of therapeutic efficacy and sustainability of results.

中文翻译：

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用于失眠的数字认知行为疗法-格鲁吉亚第一版。我们可以在实践中使用它吗？

失眠是一种常见的睡眠障碍，患病率为5–6％，并具有很高的社会影响力。至少有10％的失眠患者会去看医生。因此，佐治亚州有20,000–40,000人需要失眠的医疗帮助。失眠的治疗非常有效。药物治疗很普遍，但是公认的是认知行为疗法（CBT）是更好的选择，因为它对患者安全并且显示出可持续的改善。佐治亚州目前无法提供失眠的CBT。我们研究的目的是从治疗效果，依从性和易用性方面评估乔治亚州版本的互联网提供的创新数字CBT（dCBT）。乔治亚州针对失眠症的数字认知行为疗法被开发为荷兰dCBT“ i-Sleep”的类似物。”所有在线材料都通过翻译，通过翻译回原始语言进行验证以及适应格鲁吉亚现实的方式而适用于格鲁吉亚人口，从而避免了语言，文化和社会上的陷阱。本研究共招募了52名失眠成人患者：34名女性和18名男性，年龄18-64岁（平均33.5岁）。纳入标准包括：年龄在18岁以上，可以访问互联网以及足够的使用电子设备的技能。接受药理治疗的患者继续接受常规药物治疗，除此治疗外还接受了dCBT。DCBT由治疗师指导。根据dCBT之前和完成后一个月测量的失眠严重程度指数（ISI）评估临床疗效。52名患者中有25名（48％）完成了完整的dCBT过程。该组中的平均ISI从22.88降至8.24（P <0.01），显示出CBT完成后一个月的显着治疗效果。27位患者（52％）因各种原因在dCBT的不同阶段停止了治疗。从第一个模块中退出的有16位患者（占31％）。7位年龄超过50岁的患者在处理电子设备和平台本身时遇到问题。9名患者停止了治疗，由于各种原因显示出不良的依从性，主要与寻找疗程费时且因缺乏即时治疗效果而感到失望有关。另有11例患者（21％）停止睡眠限制，发现难以完成与睡眠限制有关的任务。通常，患者发现dCBT相当全面且易于操作。该数据表明，用于失眠的佐治亚版dCBT是一种有前途的治疗工具，在功效和依从性方面可与国际类似物媲美。为了进一步评估治疗效果和结果的可持续性，需要进行更多的研究，涉及更多的患者并进行长期随访。