Project COMISA (Comorbid Insomnia and Obstructive Sleep Apnea): Investigating the effect of cognitive behavioral therapy for insomnia (CBT-I) in individuals experiencing comorbid insomnia and obstructive sleep apnea.

All participants involved with the study will receive 7 weekly treatment sessions of Cognitive Behavioural Therapy for Insomnia (CBT-I). This will be delivered via telehealth (i.e., via Zoom) with a trained clinician. All treatment sessions will take the format of individual, one-on-one sessions. Each session will run for approximately 1 hour. CBT-I is the gold-standard, multicomponent treatment for insomnia. Clinicians work with clients to help them make changes to their sleep-wake patterns, to improve sleep and sleep efficiency. This includes setting regular sleep and wake times, getting out of bed when one is unable to sleep, sleep restriction and stimulus control. Cognitive restructuring of common misconceptions about sleep and unhelpful thought patterns, which may be perpetuating sleep problems is incorporated into the intervention. Finally, CBT-I includes education about improving the sleep environment and relaxation techniques. Throughout the intervention, participants are encouraged to practice 1-3 strategies learnt in session in between therapy sessions. Ideally, these strategies are used daily. During the course of treatment, participants will be provided with a manual which provides detailed information about the content covered in each session for participants to reference. This manual has been developed specifically for research involving the delivery of CBT-I by Prof. Drummond and colleagues who are leading experts in the field. Currently, it is not publicly available. During the intervention, participants will be provided with, and asked to wear an actiwatch (i.e., ambulatory sleep monitoring device) and complete a daily sleep diary to monitor their sleep throughout the course of the study. Clinicians Sleep clinicians will be registered provisional psychologists, trained by Chief Investigator Prof. Drummond who has clinical expertise in treating behavioural sleep disorders including Insomnia Disorder. Clinicians will be trained using methods based on those recommended by leading experts in the field Fidelity All clinicians will be regularly evaluated to ensure they are delivering the intervention properly. All treatment sessions will be recorded over Zoom. Every session from the first two cases of each treatment and 10% of all subsequent sessions will be evaluated by a registered psychologist trained in CBT-I for treatment fidelity (based on standardised check lists of session content). All recordings will be securely stored and kept confidential. Adherence Adherence to the components/activities of CBT-I will be monitored throughout the study via the sleep diary and an adherence questionnaire administered by the clinician.