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Published on: February 17, 2023
Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis
Jeanne M Geiger-Brown1, Valerie E Rogers1, Wen Liu1
1University of Maryland School of Nursing, Department of Family and Community Health, Baltimore, MD, United States.
Cognitive behavioral therapy for insomnia (CBT-I) effectively treats insomnia, even when it occurs with medical or psychiatric conditions. This therapy offers durable improvements in sleep quality and duration for patients with comorbid insomnia.
Area of Science:
- Behavioral Medicine
- Sleep Medicine
- Psychiatry
Background:
- Cognitive behavioral therapy for insomnia (CBT-I) is a recognized treatment for primary insomnia.
- Limited synthesis exists on CBT-I's efficacy for insomnia comorbid with medical or psychiatric disorders.
- Quantifying CBT-I's effect in these complex cases is crucial for clinical practice.
Purpose of the Study:
- To systematically review and quantify the effectiveness of CBT-I for insomnia in patients with comorbid medical or psychiatric conditions.
- To assess the durability of CBT-I treatment effects in this population.
Main Methods:
- Conducted a systematic literature search from 1985 to February 2014 across multiple databases and bibliographies.
- Included randomized controlled trials (RCTs) of CBT-I in adult patients with diagnosed insomnia and a comorbid condition.
- Analyzed data from 23 studies involving 1379 patients.
Main Results:
- CBT-I significantly improved subjective sleep quality, with large effect sizes for insomnia severity and sleep quality indices.
- Sleep diaries indicated reduced sleep onset latency and wake after sleep onset, increased total sleep time, and improved sleep efficiency.
- Treatment effects were sustained up to 18 months, with actigraphy results corroborating subjective measures.
Conclusions:
- Cognitive behavioral therapy for insomnia is a highly effective and durable treatment for individuals with comorbid insomnia.
- Findings support the use of CBT-I as a first-line treatment for insomnia regardless of comorbid medical or psychiatric conditions.
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