Cognitive Behavioral Therapy for Insomnia in Alcohol-Dependent Veterans: A Randomized, Controlled Pilot Study

Area of Science:

• Psychiatry
• Sleep Medicine
• Addiction Research

Background:

• Insomnia is common in individuals recovering from alcohol dependence (AD), increasing relapse risk.
• Previous studies show cognitive behavior therapy for insomnia (CBT-I) efficacy in non-Veterans with AD.
• This study aimed to evaluate CBT-I in Veterans recovering from AD.

Purpose of the Study:

• To assess the efficacy of an 8-week CBT-I intervention in Veterans undergoing alcohol dependence recovery.
• To determine if CBT-I improves insomnia severity, sleep quality, and related psychological factors in this population.

Main Methods:

• Veterans recovering from AD were randomized to 8 weeks of CBT-I or a Monitor-Only (MO) condition.
• Participants were evaluated at baseline and 6 months post-treatment using measures of insomnia, sleep, abstinence, and psychological distress.
• Mixed-effects regression models were used to analyze outcome differences between groups.

Main Results:

• CBT-I significantly improved Insomnia Severity Index (ISI) scores and reduced sleep latency compared to MO.
• Participants in the CBT-I group showed significant improvements in Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS) and Sleep Hygiene Index (SHI) scores.
• While percent days abstinent (PDA) and Quick Inventory of Depressive Symptoms (QIDS) scores improved over time, no significant differences were observed between the CBT-I and MO groups.

Conclusions:

• CBT-I is effective in reducing insomnia, negative sleep cognitions, and improving sleep hygiene among Veterans in early alcohol dependence recovery.
• The study did not find evidence that CBT-I reduces drinking behavior or anxiety in this population.
• Further research may be needed to explore combined interventions for insomnia and alcohol use disorder in Veterans.