Sleeping for Two: Study protocol for a randomized controlled trial of cognitive behavioural therapy for insomnia in pregnant women

Insomnia and sleep disturbances are common in pregnancy and have potentially significant consequences for both maternal and infant health. There is limited research examining the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) during pregnancy. With increased distress and limited access to services during the COVID-19 pandemic, there is also an unprecedented need for telehealth delivery of treatment programs for pregnant women. The primary aim of the trial is to evaluate the impact of in-person or telehealth cognitive behavioural therapy for insomnia (CBT-I) versus a treatment as usual (TAU) control group in reducing symptoms of insomnia experienced in pregnancy. We hypothesize that participants who receive CBT-I delivered in person or via telehealth will report fewer insomnia symptoms. The secondary aims are to investigate if CBT-I versus TAU increases gestational length and reduces symptoms of depression. We hypothesize that receiving CBT-I will be associated with longer gestational length (as confirmed by public health records) and lower depressive symptoms.