Brief CBT-I for insomnia comorbid with social phobia: A case study

Despite an obvious link between social anxiety and acute state of insomnia, chronic types of sleep disturbances in people with social phobia have so far received limited research/clinical attention. This case report aims to illustrate the possibility of rectifying sleep disturbances comorbid with social phobia, using a brief cognitive behaviour therapy for insomnia (CBT-I).

Treatment involved five sessions of CBT-I provided individually on a weekly basis. Major treatment components included psychoeducation, sleep restriction therapy, stimulus control and cognitive restructuring.

Treatment effects were assessed using sleep diary and questionnaires over the course of the treatment and at ~9 month follow-up. The results were encouraging with all targeted sleep parameters demonstrating improvements that met dual criteria for clinical significance. The gains were well maintained even at ~9 months after treatment. These improvements in sleep were accompanied by a reduction in sleep-related anxiety and dysfunctional beliefs and attitudes about sleep. Whilst the patient also reported a corresponding improvement in daytime functioning and general anxiety, no gains were observed in depression and social anxiety.

These findings highlight the potential benefits of incorporating brief CBT-I into existing treatments for social phobia and encourage further research on the intricate relationship between sleep, mood and social anxiety.