Sleep Best-i: An online cognitive-behavioural intervention for the treatment of insomnia and nightmares in wildfire survivors

None listed

Wildfires are natural phenomena that affect people living in many parts of the world including: Australia, Europe, Asia, and North and South America (Bowman et al., 2017; Mcrae & Sharples, 2015; Strauss et al.,1989; Williams, 2013). Bushfires result in injury and loss of human lives, disruption to community cohesion, people’s sense of belonging, safety and wellbeing, and displacements of entire communities (Berry et al., 2010; Guha-Sapir et al., 2015). Bushfires also lead to an increased prevalence of mental health disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbances (Agyapong et al., 2019; Lowe et al., 2018; Willis, 2020). The presence of sleep disturbances in those who experience trauma, exacerbates and/or maintains PTSD severity (Babson & Feldner, 2010). Moreover, chronic sleep disturbances can lead to poor physical and psychological health, poor quality of life, impaired social relations and suicidal ideation (Morgan et al., 2015; Nadorff et al., 2011; Roth & Ancoli-Isreal, 1999; Simon & VonKorff, 1997; Uchmanowicz et al., 2019). However, despite the negative impact of sleep disturbances on quality of life and their consequences on the development of trauma symptomology, research in this area is limited (Babson & Feldner, 2010). Studies suggest that treating sleep disturbances in those presenting with PTSD leads to better outcomes in terms of both improved sleep and also reduced trauma symptoms (Colvonen et al., 2018). In a meta-analysis of 11 randomised controlled trials that assessed the effectiveness of cognitive behavioural therapy for insomnia (CBT-I), imagery rehearsal therapy (IRT), and exposure, relaxation and rescripting therapy (ERRT), found that these treatments significantly improved sleep quality and also reduced PTSD symptoms, with a moderate effect size of ES = 0.6, for the treatment group in comparison to waitlist groups (Ho et al., 2016). The COVID-19 pandemic changed the way we live. It has also changed the way we receive and provide health care (Isaac et al., 2022). Digital therapies are becoming more popular and are in high demand given the shortage of well-trained counsellors/ psychologists particularly in regional and remote locations. Better and more successful treatment methods for those exposed to bushfires will inform policy makers in navigating where investments in health care should be targeted, such as the provision and timing of treatments designed to improve sleep and reduce trauma symptoms (Siegel et al., 2004; Van Kamp et al., 2006). This will reduce both the burden of sleep disturbances and the subsequent development of serious psychopathology in communities (Babson & Feldner, 2010; Colvonen et al., 2018). Key research question: How effective is Sleep Best-i in reducing symptoms of insomnia and nightmares in bushfire survivors?