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Sleep spindles may predict response to cognitive-behavioral therapy for chronic insomnia
Thien Thanh Dang-Vu1, Benjamin Hatch2, Ali Salimi3
1Department of Exercise Science, Concordia University, Montréal, QC, Canada; Department of Psychology, Concordia University, Montréal, QC, Canada; Center for Studies in Behavioral Neurobiology, Concordia University, Montréal, QC, Canada; PERFORM Center, Concordia University, Montréal, QC, Canada; Center for Clinical Research in Health, Concordia University, Montréal, QC, Canada; Centre de Recherches de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada; Department of Neurosciences, Université de Montréal, Montréal, QC, Canada.
Lower pre-treatment sleep spindle density predicts poorer response to cognitive-behavioral therapy for insomnia over 12 months. This suggests sleep spindle density may be a biomarker for treatment effectiveness in chronic insomnia patients.
Area of Science:
- Neuroscience
- Sleep Medicine
- Psychiatry
Background:
- Cognitive-behavioral therapy for insomnia (CBT-I) is a first-line treatment for chronic insomnia.
- Limited research explores the relationship between sleep architecture and CBT-I response.
- This study investigates pre-treatment sleep spindle density as a predictor of CBT-I treatment response.
Purpose of the Study:
- To determine if pre-treatment sleep spindle density predicts treatment response to CBT-I.
- To identify potential neurophysiological biomarkers for CBT-I responsiveness.
Main Methods:
- 24 participants with chronic primary insomnia underwent a 6-week group CBT-I.
- Treatment response was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) at multiple time points.
- Pre-treatment polysomnography was used to measure sleep spindle density during N2-N3 sleep.
Main Results:
- Lower pre-treatment sleep spindle density predicted poorer 12-month PSQI outcomes.
- Reduced spindle density correlated with less improvement in sleep diary sleep efficiency and wake after sleep onset post-treatment.
- No significant associations were found between spindle density and ISI changes or other polysomnography variables.
Conclusions:
- Pre-treatment sleep spindle density may serve as an endogenous biomarker for predicting CBT-I responsiveness in insomnia.
- Insomnia with altered spindle activity could represent a subtype with neurophysiological vulnerability, potentially leading to impaired CBT-I response.
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