A Computerized Cognitive Behavioral Therapy Randomized, Controlled, Pilot Trial for Insomnia in Parkinson's Disease (ACCORD-PD Study) (P4.333)

Objective: To demonstrate benefit of computerized cognitive behavioral therapy for insomnia in Parkinson disease (PD) patients. Background: PD is associated with a high prevalence of sleep disorders affecting up to 82[percnt] of patients. Despite the high prevalence and life-quality impact of insomnia in PD, there are only a few pharmacotherapy studies in literature. Cognitive behavioral therapy (CBT) is a treatment option and its durable effects have been shown in primary insomnia; however it has not been tested in PD. We have developed a novel online Computerized Cognitive Behavioral Therapy for Insomnia (CCBT-I). The CCBT-I program involves a 6-week course in a series of daily lessons, homework assignments, learnable skills and appropriate recommendations. Methods: We conducted a single-center, pilot, randomized controlled trial on CCBT-I. Twenty-eight subjects with PD experiencing insomnia defined by a score >11 on Insomnia Severity Index (ISI) were recruited. Patients with severe dementia, depression, other sleep disorders or on other sleep aids were excluded. Patients were randomized to either the CCBT-I 6-week treatment arm or the control treatment arm consisting of hard copy good sleep hygiene advice (No computer required). Results: Among the 28 patients (16:12 M:F; mean age 63.9 years), 8/14 in the treatment group and 13/14 in control group completed the study. ISI scores decreased from baseline to endpoint in both treatment (p<0.002) and control( p<0.008). The ISI decreased more in treatment than control (p=0.03). Conclusions: This pilot study shows that CCBT-I can be an effective treatment option for PD patients with insomnia when used in its full duration. We had more than anticipated dropout rate suggesting the program can be challenging for PD patients due to some patients had a difficult time keeping up with daily logs. Larger randomized control studies are needed to further evaluate our findings. Disclosure: Dr. Patel has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Foldvary received support from UCB and CleveMed. Dr. Ojo has nothing to disclose. Dr. Genc has nothing to disclose. Dr. Oravivattanakul has nothing to disclose. Dr. Fernandez has received personal compensation for activities with Prime Education Inc, International Parkinson and Movement Disorders Society, Carling Communications, Medscape, Biogen, GE Health Care, Lundbeck, Merz Pharmaceuticals and Pfizer Pharmaceu