Objective/Background: Insomnia commonly co-occurs with chronic migraines (CM). Non-pharmacological treatments for insomnia in CM patients remain understudied. This is a proof-of-concept study, which aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital cognitive behavioral therapy for insomnia (dCBT-I) for individuals with CM and insomnia (CM-I) in the United States. Methods: We recruited 42 females with CM-I symptoms from a U.S.-based observational cohort and from the general population via advertisements. Within a multiple baseline design, participants were randomized to receive dCBT-I after 2, 4, or 6 weeks of completing baseline sleep diaries. DCBT-I was scrutinized against benchmarks for completion rates (≥90% to complete dCBT-I), acceptability (≥80% to find dCBT-I acceptable), and posttreatment changes in insomnia symptoms (≥50% indicating a clinically relevant improvement in their insomnia symptoms). As a secondary measure, we also reported percentage of individuals reverting to episodic migraines. Results: Out of 42 randomized, 35 (83.3%) completed dCBT-I within the 12 weeks provided. Of these completers, 33 (94.3%) reported being satisfied (n = 16) or very satisfied (n = 17) with treatment. Additionally, 65.7% of completers responded to treatment as per universally accepted criteria for insomnia. Lastly, 34% of completers reverted from CM to episodic migraine. Conclusion: This study provides evidence for the feasibility and acceptability of dCBT-I in patients with CM-I complaints. Effects of improving insomnia and migraines were suggested. These results indicate that a randomized controlled trial is needed to determine the efficacy of dCBT-I in CM patients.

Additional Metadata
Keywords cognitive behavior therapy, digital, insomnia, migraine
Persistent URL dx.doi.org/10.1111/head.13777, hdl.handle.net/1765/125480
Journal Headache: the journal of head and face pain
Citation
Crawford, M.R. (Megan R.), Luik, A.I, Espie, C.A. (Colin A.), Taylor, H.L. (Hannah L.), Burgess, H.J. (Helen J.), Jones, A.L. (Alex L.), & Ong, J.C. (Jason C.). (2020). Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines. Headache: the journal of head and face pain. doi:10.1111/head.13777