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Cognitive-behavior therapy for late-life insomnia

C M Morin1, R A Kowatch, T Barry

  • 1Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0268.

Journal of Consulting and Clinical Psychology
|February 1, 1993
PubMed
Summary
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Cognitive-behavior therapy effectively treats insomnia in older adults by improving sleep habits and beliefs. These nonpharmacological interventions lead to lasting sleep improvements, validated by patients and their families.

Area of Science:

  • Gerontology
  • Sleep Medicine
  • Behavioral Therapy

Background:

  • Persistent psychophysiological insomnia is common in older adults.
  • Nonpharmacological interventions are sought for late-life insomnia.
  • Cognitive-behavior therapy (CBT) shows promise for sleep disorders.

Purpose of the Study:

  • To evaluate the efficacy of cognitive-behavior therapy (CBT) for persistent psychophysiological insomnia in older adults.
  • To assess the maintenance of treatment gains over time.
  • To compare objective and subjective sleep measures.

Main Methods:

  • Randomized controlled trial with a waiting-list control group.
  • 24 older adults with insomnia received an 8-week group CBT intervention.
  • Sleep latency, wake after sleep onset, early morning awakening, and sleep efficiency were measured using sleep diaries and polysomnography.

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  • Follow-up assessments at 3 and 12 months.

    • Main Results:

    • CBT significantly reduced sleep latency, wake after sleep onset, and early morning awakening.
    • Sleep efficiency significantly increased following CBT.
    • Objective polysomnographic measures showed smaller, but consistent, improvements compared to subjective sleep diaries.
    • Treatment gains were maintained at 3- and 12-month follow-ups.

    Conclusions:

    • Cognitive-behavior therapy is an effective nonpharmacological treatment for insomnia in older adults.
    • CBT leads to significant and sustained improvements in sleep parameters.
    • This intervention offers a viable alternative to medication for late-life insomnia.