Internet-guided cognitive, behavioral and chronobiological interventions in depression-prone insomnia subtypes: protocol of a randomized controlled prevention trial

Jeanne Leerssen*, Jessica C. Foster-Dingley, Oti Lakbila-Kamal, Laura M. S. Dekkers, Anne C. W. Albers, Savannah L. C. Ikelaar, Teodora Maksimovic, Rick Wassing, Simon J. Houtman, Tom Bresser, Tessa F. Blanken, Bart te Lindert, Jennifer R. Ramautar, Eus J. W. Van Someren

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Citations (Scopus)
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BACKGROUND: Major depressive disorder is among the most burdening and costly chronic health hazards. Since its prognosis is poor and treatment effectiveness is moderate at best, prevention would be the strategy of first choice. Insomnia may be the best modifiable risk factor. Insomnia is highly prevalent (4-10%) and meta-analysis estimates ±13% of people with insomnia to develop depression within a year. Among people with insomnia, recent work identified three subtypes with a particularly high lifetime risk of depression. The current randomized controlled trial (RCT) evaluates the effects of internet-guided Cognitive Behavioral Therapy for Insomnia (CBT-I), Chronobiological Therapy (CT), and their combination on insomnia and the development of depressive symptoms.

METHODS: We aim to include 120 participants with Insomnia Disorder (ID) of one of the three subtypes that are more prone to develop depression. In a two by two factorial repeated measures design, participants will be randomized to CBT-I, CT, CBT-I + CT or treatment as usual, and followed up for one year. The primary outcome is the change, relative to baseline, of the severity of depressive symptoms integrated over four follow-ups spanning one year. Secondary outcome measures include a diagnosis of major depressive disorder, insomnia severity, sleep diaries, actigraphy, cost-effectiveness, and brain structure and function.

DISCUSSION: Pre-selection of three high-risk insomnia subtypes allows for a sensitive assessment of the possibility to prevent the development and worsening of depressive symptoms through interventions targeting insomnia.

TRIAL REGISTRATION: Netherlands Trial Register (NL7359). Registered on 19 October 2018.

Original languageEnglish
Article number163
Pages (from-to)1-11
Number of pages11
JournalBMC Psychiatry
Issue number1
Publication statusPublished - 15 Apr 2020
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • insomnia
  • depression
  • cognitive behavioral therapy for insomnia
  • chronobiological therapy
  • randomized controlled trial


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