A Sound Approach: Is Digital Behavioral Insomnia Therapy Accessible for the Deaf Community?

Document Type

Conference Proceeding

Publication Date

5-19-2025

Publication Title

Sleep

Abstract

Introduction: Prior research has demonstrated that digitally delivered CBT for Insomnia (dCBT-I) is highly effective for those who can access and complete treatment. However, there are significant accessibility challenges for many vulnerable pop ulations. Extant studies have focused on those with low socio economic (SES) resources and/or low digital health literacy; however, the accessibility of dCBT-I for people with hearing disabilities has not been well-established. This study conducted qualitative interviews with dCBT-I patients from various back grounds about treatment adherence and the addition of a nurse coach. Methods: Patients (n=263) had an initial telehealth consultation with the coach, then completed six consecutive weeks dCBT-I sessions via a mobile health application alongside sleep diaries which tracked sleep efficiency, sleep restriction, and time in bed. Patients received personalized feedback from the coach after each session and had the option of booking additional telehealth coaching sessions. Qualitative interviews were conducted with a subsample of patients to assess adherence across ability, SES, and treatment completion barriers and facilitators using the NIMHD framework. Results specifically pertinent to those with hearing disability are presented here. Results: While patients with hearing disabilities were able to suc cessfully complete the treatment, there were several barriers and facilitators named. Patients found that specific digital tools that are usually not available (e.g., chat box, live closed captioning) were integral to their ability to fully participate in the treatment. Patients with a hearing disability often relied on their own tools and strategies (e.g., translation services, microphones) to make the treatment recommendations feasible. Patients also noted that having a coach aided in treatment adherence, specifically refer encing the importance of receiving encouragement as an impor tant factor in their own treatment continuation. Conclusion: This feedback highlights the importance of aug menting dCBT-I with relevant tools and technology to increase accessibility to those with a hearing disability. Though the dig ital administration of CBT-I already has tools that increase accessibility compared to in-person treatment, those were not sufficient. Future research should further examine how imple mentation of dCBT-I can have greater equitable access for disa bled communities. Support (if any): R01HL159180 awarded to Dr. Philip Cheng.

Volume

48

Issue

Supplement_1

First Page

A256

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