Sleep To Reduce Incident Depression Effectively

This project will assess the acute and long-term effectiveness of dCBT-I on Research Domain
Criteria (RDoC) sleep parameters: Insomnia Severity Index (ISI), sleep onset latency, and
wake after sleep onset in an insomnia cohort including those at elevated risk for depression
(e.g. high sleep reactivity, low SES, minority). This will be tested by administering
internet-based dCBT-I to people with insomnia and adding face-to-face CBT-I in non-remitters
(ISI > 10), as well aS comparing the RDoC sleep outcomes to an attention control group
post-treatment and at 1 year follow-up. This study will also determine the acute and
long-term effectiveness of face-to-face CBT-I for insomnia in non-responders to dCBT-I on
RDoC sleep outcomes relative to a comparison group post-treatment and at 1-year follow-up.

This study will also determine the effects of dCBT-I and CBT-I using a stepped-care model for
prevention of incident depression and depression relapse. The 1-year rate of depression of
both dCBT-I and CBT-I will be compared to a control group.

This study will also evaluate changes in nocturnal rumination as a modifiable behavior
(post-treatment) that mediates the effect of insomnia treatment on subsequent depression
risk. This will also determine the moderating effects of important depression risk factors
(e.g. race, SES) on the change in sleep and depression outcomes.

Inclusion Criteria:

- Determination of Insomnia (ISI > 14)

- Without Depression (QIDS < 11)

Exclusion Criteria:

- Age < 18

- Current use of antidepressants for depression

- Bipolar or Seizure disorders

- Known sleep disorders other than insomnia (e.g. obstructive sleep apnea, narcolepsy,
restless leg syndrome).