Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial

Rafihi‐Ferreira, Renatha El; Morin, Charles M.; Toscanini, Andrea Cecília; Neto, Francisco Lotufo; Brasil, Israel Soares Pompeu de Sousa; Gallinaro, João Guilherme de Mello e; Borges, D. Suzuki; Conway, S.G.; Hasan, Rosa

doi:10.1590/1516-4446-2020-0947

Cited by 17 publications

(10 citation statements)

References 15 publications

(33 reference statements)

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“…More recently, a reduction in psychological inflexibility and parallel improvement in sleep quality has also been observed in participants with insomnia (Chapoutot et al, 2021;El Rafihi-Ferreira et al, 2020;Paulos-Guarnieri et al, 2022). Interestingly, even though ACT does not have a therapeutic focus on dysfunctional beliefs about sleep, studies have reported reduced DBAS scores after ACT-I-based treatment (El Rafihi-Ferreira et al, 2020;Päivi et al, 2019;Zakiei et al, 2021;Zakiei & Khazaie, 2019). Similarly, El Rafihi-Ferreira et al ( 2020) found a reduction in AAQ-II scores after CBT-I treatment, even though CBT did not have a direct focus on psychological flexibility.…”

Section: Discussionmentioning

confidence: 94%

“…Several studies have shown a reduction in dysfunctional beliefs about sleep, with a concomitant reduction in the severity of insomnia (Lance et al, 2019;Thakral et al, 2020). More recently, a reduction in psychological inflexibility and parallel improvement in sleep quality has also been observed in participants with insomnia (Chapoutot et al, 2021;El Rafihi-Ferreira et al, 2020;Paulos-Guarnieri et al, 2022). Interestingly, even though ACT does not have a therapeutic focus on dysfunctional beliefs about sleep, studies have reported reduced DBAS scores after ACT-I-based treatment (El Rafihi-Ferreira et al, 2020;Päivi et al, 2019;Zakiei et al, 2021;Zakiei & Khazaie, 2019).…”

Section: Discussionmentioning

confidence: 99%

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Cognitive and psychological factors associated with severe insomnia in Brazilian women: a cross-sectional study

Rafihi‐Ferreira

Carmo

Bassolli

et al. 2022

Psicol. Refl. Crít.

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Insomnia is the most prevalent sleep disorder in women. Sociodemographic, cognitive, and psychological factors may contribute to its severity. This study evaluated factors associated with severe insomnia in women with insomnia complaints. We evaluated 530 women aged 18–59 (mean = 40.5, SD = 10.2), who experienced insomnia complaints, using self-report instruments. Severe insomnia was defined as a score above 21 on the Insomnia Severity Index. Age, marital status, educational level, depression and anxiety, psychological inflexibility, and beliefs about sleep were assessed as potential factors associated with severe insomnia. Simple and multivariate analyses were conducted using binary logistic regression. Low education level (odds ratio; OR = 1.85 [1.27–2.69]), depression (OR = 2.17 [1.27–3.81]), psychological inflexibility (OR = 1.05 [1.02–1.08]), and dysfunctional beliefs about sleep (OR = 1.04 [1.02–1.06]) were factors associated with severe insomnia scores in the multiple logistic regression model. These findings are important from a public health perspective, because behavioral strategies designed to treat insomnia with a focus on cognitive and psychological factors are low-cost treatments and may help improve sleep quality in women, which also influences mental health.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Cognitive and psychological factors associated with severe insomnia in Brazilian women: a cross-sectional study

Rafihi‐Ferreira

Carmo

Bassolli

et al. 2022

Psicol. Refl. Crít.

Self Cite

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“…Por exemplo, protocolos de tratamento em grupo a partir dos pressupostos da ACT mostraram-se eficazes para o manejo de transtorno de humor bipolar (Machado et al, 2019) e de insônia (El Rafihi-Ferreira et al, 2020). Ainda, em um estudo sobre ACT em grupo para ansiedade, por meio de um relato de experiência, os autores concluíram que a proposta parecia exercer efeito positivo no manejo de ansiedade, mas que estudos futuros com experimentos controlados poderiam confirmar essa hipótese (Chagas et al, 2013).…”

Section: Discussionunclassified

“…Silva & de-Farias, 2013;Sousa & de-Farias, 2014;Vogel, Gordon, & Lotufo Neto, 2017). Contudo, a utilização da ACT em modalidade grupal no país ainda é incipiente, com resultados de pesquisas para insônia (El Rafihi-Ferreira et al, 2020) e Transtorno de Humor Bipolar (Machado, Soares, & Costa, 2019). Além disso, foi identificado apenas um estudo no Brasil relatando a aplicabilidade dos princípios da ACT em grupo para ansiedade (Chagas, Guilherme, & Moriyama, 2013).…”

Section: Introductionunclassified

ACT em Grupo para Manejo de Ansiedade entre Universitários: Ensaio Clínico Randomizado

Almeida

Demenech

Sousa-Filho

et al. 2022

Psicol. cienc. prof.

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Resumo Estima-se que um a cada cinco estudantes universitários ao redor do mundo apresenta algum tipo de transtorno psicológico, dentre os quais os transtornos de ansiedade são os mais prevalentes. Este estudo consiste em um ensaio clínico randomizado com o objetivo de avaliar a eficácia e efetividade de um protocolo semiestruturado de psicoterapia em grupo baseado nos princípios da Terapia de Aceitação e Compromisso (ACT) para o tratamento de ansiedade entre estudantes universitários. Os participantes foram alocados aleatoriamente entre os grupos intervenção e controle. Os níveis de ansiedade pré e pós-intervenção foram avaliados por meio do instrumento General Anxiety Disorders-7 (GAD-7). A amostra final do estudo foi composta por 15 pessoas, dentre as quais 10 foram alocadas no grupo intervenção e 5, no grupo controle. Os resultados foram analisados de duas formas: a) por protocolo (Per-protocol analysis); e b) por intenção de tratar (Intention-to-treat Analysis). Este tratamento reduziu a sintomatologia ansiosa em 39,7% entre os pacientes que completaram o tratamento (por protocolo, p=0,030) e em 30,8% entre todos alocados para o grupo intervenção (i.e., por intenção de tratar, incluindo os dropouts, p=0,035), enquanto os controles não tiveram redução significativa no mesmo período. Portanto, recomenda-se a utilização deste protocolo dentro do contexto universitário como uma alternativa viável ao acompanhamento individual em situações de transtornos de ansiedade. Pesquisas futuras com amostras maiores podem contribuir na consolidação deste protocolo.

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“…While ACT was shown to be superior to an active control condition (Zakiei et al, 2021), it was inferior to CBT‐I (El‐Rafihi‐Ferreira et al, 2022). Moreover, replacing the cognitive therapy aspect of CBT‐I with ACT did not enhance efficacy (El Rafihi‐Ferreira et al, 2021). Finally, one study of a web‐based treatment platform using ACT, SRT and SCT found it was superior to waitlist control conditions (Chapoutot et al, 2021).…”

Section: Treatment Of Insomniamentioning

confidence: 99%

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023

Riemann,

Espie,

Altena

et al. 2023

Journal of Sleep Research

107

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SummaryProgress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential‐diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders, etc.), treatment‐resistant insomnia (A) and for other indications (B). Cognitive‐behavioural therapy for insomnia is recommended as the first‐line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in‐person or digitally (A). When cognitive‐behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low‐dose sedating antidepressants (B) can be used for the short‐term treatment of insomnia (≤ 4 weeks). Longer‐term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged‐release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast‐release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive‐behavioural therapy for insomnia (B).

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Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial

Cited by 17 publications

References 15 publications

Cognitive and psychological factors associated with severe insomnia in Brazilian women: a cross-sectional study

Cognitive and psychological factors associated with severe insomnia in Brazilian women: a cross-sectional study

ACT em Grupo para Manejo de Ansiedade entre Universitários: Ensaio Clínico Randomizado

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023

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