0408 Predictors of Responders in Sleep Hygiene Education: A Secondary Analysis of Randomized Controlled Trials

Abstract Introduction Few studies have investigated the predictors of the treatment response after attending sleep hygiene education (SHE). We aimed to explore the patient characteristics associated with a response to SHE for insomnia. Methods A secondary analysis was conducted to pool the data of two randomized controlled trials for insomnia (Trial registration number ClinicalTrials.gov: #NCT04227587; NCT03623438), in which the subjects in the comparison group had attended two 2-hour sessions (total 4 hours) of small-group based SHE. We examined the association of sociodemographic variables, clinical characteristics, baseline sleep-wake variables, and Sleep Hygiene Practice Scale (SHPS) items to the treatment response. Subjects with a reduction in insomnia severity index (ISI) scores of ≥ 6 points from baseline to week 8 were classified as responders. Factors were compared between responders and non-responders and by univariate and multivariate logistic regression analysis. Results A total of 170 subjects with insomnia disorder who had received the SHE program were included and 42 (24.7%) of them were classified as responders. At 8 weeks after baseline, the subjects showed a 2.88 points reduction in ISI total score, 11.5 minutes reduction in sleep onset latency, 10.4 minutes reduction in waketime after sleep onset, 20.3 minutes increase in total sleep time, and 4.42% increase in sleep efficiency. Univariate logistic regression analysis has identified 12 potential predictors for SHE responders, including age, gender, baseline sleep parameters, and SHPS items. In the multivariate logistic regression analysis, age, ever tried exercise for improving sleep, and baseline ISI score remained significant predictors of SHE treatment response (age, adjusted OR 0.88, 95%CI 0.79, 0.97, p = 0.011; ever tried exercise for improving sleep, adjusted OR 11.0, 95%CI 1.16, 104.9, p = 0.037; baseline ISI score, adjusted OR 1.59, 95%CI 1.15, 2.19, p = 0.005). Conclusion Lower age, higher baseline ISI score, and ever-tried exercise for improving sleep were shown to predict the response of SHE. Our findings inform individuals who have insomnia to select the treatment for chronic insomnia in the future. Support (if any) The RCTs were supported by the Research Grants Council, General Research Fund (NCT04227587, Project no.: 15100419), and Health and Medical Research Fund (NCT03623438, Project no.: 19200171).