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Cognitive-Behavioral Therapy for Insomnia Tailored to Patients With Cardiovascular Disease: A Pre-Post Study
Adam Heenan1, Andrew Pipe1,2, Kyle Lemay1
1Division of cardiac prevention and rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Insights
Cognitive-behavioral therapy for insomnia (CBT-I) improved sleep and reduced anxiety and depression in cardiovascular disease patients. This tailored group intervention shows promise for better patient outcomes.
Area of Science:
- Cardiology
- Sleep Medicine
- Psychiatry
Background:
- Limited research exists on cognitive-behavioral therapy for insomnia (CBT-I) in cardiovascular disease (CVD) patients.
- Fewer studies explore CBT-I's impact on CVD risk factors like anxiety and depression.
- Efficacy of modified CBT-I protocols for cardiac patients requires further investigation.
Purpose of the Study:
- To evaluate a group-based CBT-I intervention specifically tailored for patients with CVD.
- To assess the intervention's effects on sleep quality, duration, and mental health.
- To determine the feasibility of a modified CBT-I protocol in a cardiac population.
Main Methods:
- A pre-post design was employed to compare outcomes before and after the intervention.
- 47 participants with primary insomnia and CVD were included.
- A six-week group CBT-I intervention, modified for cardiac patients, was administered, with sleep diaries and validated questionnaires used for assessment.
Main Results:
- Significant improvements were observed in sleep outcomes, including duration, maintenance, efficiency, latency, and quality.
- Participants reported substantial reductions in symptoms of anxiety, depression, and insomnia.
- All improvements were statistically significant (p < .05).
Conclusions:
- A group-based CBT-I intervention tailored for cardiac patients effectively improved sleep.
- The intervention also led to significant reductions in anxiety and depression levels.
- Randomized controlled trials are recommended to further validate these findings.
Abstract:
Objective: There is little research assessing the use of cognitive-behavioral therapy for insomnia (CBT-I) among patients with cardiovascular disease (CVD), even less on the effects of CBT-I on CVD risk factors such as anxiety and depression, and to our knowledge, only limited studies of the efficacy of CBT-I protocols with cardiac disease-specific modifications. The objective of this study is to evaluate a group-based CBT-I intervention tailored to patients with CVD on sleep quality, duration, and mental health. Participants: A sample of 47 participants (25 men) diagnosed with primary insomnia were included in this study. Methods: This study used a pre-post design comparing outcomes before and after a group intervention. Clinicians in a cardiac center referred CVD patients with self-reported sleep disturbance to the intervention group. Following screening and confirmation of insomnia disorder, participants completed a six-week CBT-I group-based intervention tailored for patients with CVD. Participants completed sleep diaries and questionnaires, including the Insomnia Severity Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, pre- and postintervention. Results: Participants' sleep outcomes (sleep duration, maintenance, efficiency, latency, and quality) were significantly improved and patients reported significantly fewer symptoms of anxiety, depression, and insomnia following the CBT-I intervention (p values < .05). Conclusions: After participating in a CBT-I group intervention tailored for cardiac patients, patients reported improved sleep and significantly lower levels of anxiety and depression. Randomized trials of this intervention are warranted.
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