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Adherence to cognitive behavioral therapy for insomnia: a systematic review
Ellyn E Matthews1, J Todd Arnedt, Michaela S McCarthy
1University of Colorado Denver, College of Nursing, Aurora, CO 80045, USA.
Sleep Medicine Reviews
|April 23, 2013
Summary
Adherence to cognitive behavioral therapy for insomnia (CBTI) is crucial for treatment success. This review synthesizes studies on CBTI adherence, highlighting inconsistencies and the need for standardized measures to improve patient outcomes.
Area of Science:
- Sleep Medicine
- Behavioral Science
- Public Health
Background:
- Chronic insomnia presents significant global health and economic burdens.
- Cognitive behavioral therapy for insomnia (CBTI) is effective, but adherence challenges limit its impact.
- Understanding adherence to CBTI is vital for optimizing treatment efficacy.
Purpose of the Study:
- To systematically review and synthesize the literature on adherence to CBTI.
- To analyze adherence rates, influencing factors, and impact on treatment outcomes.
- To identify gaps in measurement and suggest future research and clinical directions.
Main Methods:
- Comprehensive literature search for studies evaluating CBTI adherence in adults.
- Inclusion of 15 studies using validated sleep and adherence measures (excluding withdrawals).
- Synthesis of study characteristics, methodologies, adherence data, and outcome correlations.
Main Results:
- Identified significant patterns and inconsistencies across studies regarding adherence.
- Adherence rates and contributing factors varied, complicating direct outcome evaluation.
- Measurement issues in assessing adherence and outcomes were prevalent.
Conclusions:
- Adherence is a critical factor in CBTI success, yet its role is complex and not fully understood.
- Standardized measures for adherence and outcomes are essential for future research and clinical practice.
- Improved understanding and measurement of adherence can enhance CBTI intervention effectiveness.
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