One-Session Cognitive Behavioural Therapy for Insomnia in Integrated Primary Care: A Preliminary Study

Chronic insomnia is commonly reported in primary care settings. One-session cognitive behavioural therapy for insomnia (CBT-I) is a brief intervention designed to fit the fast-paced nature of primary care but has not been studied in this context. This preliminary study assessed the effectiveness of one-session CBT-I in an integrated primary care clinic. Adult patients (N = 37) with clinically elevated insomnia symptoms were randomly assigned to receive either one-session CBT-I (n = 17) or an active attentional control (n = 20). The primary outcomes included insomnia symptoms, total wake time (TWT) and sleep efficiency (SE). Outcomes were assessed at baseline, post-treatment, 1-month post-treatment and 3-months post-treatment. At post-treatment, the CBT-I group showed greater improvements than the control group in TWT and SE, and these differences persisted at the 1-month follow-up. The CBT-I group also demonstrated larger reductions in insomnia symptoms than controls at 1- and 3-month follow-ups. More specifically, the CBT-I group demonstrated significant improvements in TWT, mean (SD) change = -57.0 min (57.5) and SE, mean (SD) change = 8.8% (9.3). At 1 month, these improvements persisted, with sustained improvements in TWT, mean (SD) change = -62.1 min (44.3) and SE, mean (SD) change = 10.8% (9.5), for the CBT-I group. Additionally, CBT-I participants reported significantly lower insomnia symptoms at 1 month, mean (SD) change = -6.4 (3.9) and 3 months post-treatment, mean (SD) change = -7.3 (4.2). This study provides preliminary support for using one-session CBT-I to treat clinically elevated insomnia symptoms in primary care.