Cognitive behavior therapy for older adults with insomnia and depression: a randomized controlled trial in community mental health services

Sadler, Paul; McLaren, Suzanne; Klein, Britt; Harvey, Jack; Jenkins, Megan

doi:10.1093/sleep/zsy104

Cited by 70 publications

(78 citation statements)

References 53 publications

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“… 29 Cognitive behavior therapy has been shown to be effective at reducing insomnia and depression severity for older adults, and it has been demonstrated that mental health services can improve recovery outcomes for older adults with depression. 30 It is important to design interventions aimed at decreasing the effects of insomnia in surgical patients to improve their health and quality of life. The ever-increasing rate of sleep disorders means identifying modifiable risk factors is of the utmost importance.…”

Section: Discussionmentioning

confidence: 99%

The Association of Insomnia with Depression and Anxiety Symptoms in Patients Undergoing Noncardiac Surgery

Huang¹,

Wu²,

Wu³

et al. 2021

NDT

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Objective Insomnia is common in patients undergoing surgery. It can increase the rate of postoperative complications, interfere with patient recovery, and decrease hospital satisfaction. However, there are few studies on perioperative insomnia. This study was conducted to investigate the differences in the demographic, health status, and clinical characteristics of patients with and without insomnia postoperatively, and to identify the potential risk factors of insomnia. Methods There were 299 non-cardiac surgery patients, 165 females, and 134 males, with a mean age of 55 years, enrolled in the study. The Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), and Montreal Cognitive Assessment (MoCA) were administered to all the patients preoperatively. The Visual Analogue Scale (VAS) was used preoperatively, and at the end of the surgery, and then one day, two days, and three days after surgery. The PHQ-9, the GAD-7, and the ISI were repeated three days after surgery. Insomnia was diagnosed by the ISI as being a score of 8–28 (mild: 8–14; moderate-severe: 15–21; severe: 22–28). The patients were divided into group A (with insomnia, N=78) and group B (without insomnia, N=221) according to their ISI score three days after surgery. The general clinical data of the two groups were analyzed first, and then binary logistic regression analysis was conducted to assess the risk factors of insomnia. Results A total of 299 non-cardiac surgery patients with a mean age of 55 years were enrolled in the study. Of the included patients, the number of females was 165 and the number of the male was 134. The incidence of insomnia at 3 days postoperatively was 26.1% (78/299). The average points that group A patients scored in the ISI, PHQ-9, and the GAD-7 were significantly higher than those in group B. The VAS score three days after surgery was significantly higher in group A. The PHQ-9 and the GAD-7 three days after surgery showed significantly higher depression and anxiety scores in group A. Logistic regression showed that the ISI ( p <0.001, 95% CI=1.218–1.500) and the GAD-7 ( p =0.003, 95% CI=1.041–1.218) preoperatively, and the PHQ-9 postoperatively ( p <0.001, 95% CI=1.226–1.555), were risk factors of insomnia. Conclusion Insomnia is common and can worsen after surgery. The present study suggests that depression and anxiety are risk factors for insomnia after surgery. There is a need for further research and the development of strategies for depression and anxiety management to ensure better sleep quality for patients, which will be of significant benefit to their health. Clinical Trial Registration The study was registered at clinical trial (NCT04027751); Trial registration: clinical trial, NCT04027751. Registered 22 July 2019; https://clinical...

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Section: Discussionmentioning

confidence: 99%

The Association of Insomnia with Depression and Anxiety Symptoms in Patients Undergoing Noncardiac Surgery

Huang¹,

Wu²,

Wu³

et al. 2021

NDT

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“…The observed distributions in the insomnia were summarized in de ned groups based on the scores from ISI as follows: none (0-7), mild (8)(9)(10)(11)(12)(13)(14), moderate (15)(16)(17)(18)(19)(20)(21), severe (22)(23)(24)(25)(26)(27)(28). Depression was rate on PHQ-9 of ve levels: none (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderatesevere (15)(16)(17)(18)(19) severe (20)(21)(22)(23)(24)(25)(26)(27). Anxiety was graded according to the score of the GAD-7: none (0-4), mild (5-9), moderate (10-13), moderate-severe (14-18), severe (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive behavior therapy were both effective at reducing insomnia and depression severity for older adults. Mental health services were proved to improve recovery outcomes for older adults with depression [27]. It is important to design interventions aimed at decreasing the effects of poor sleep quality in surgical patients to support improving their health and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Insomnia is Associated with Depression and Anxiety in Patients Undergoing Noncardiac Surgery

Huang

Chen

Wang

et al. 2020

Preprint

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BackgroundTo investigate the difference of demographic, health status and clinical characteristics of patients with or without insomnia postoperatively, and to identify the potential risk factors of insomnia.Methods299 patients undergoing surgery were included. Patients were divided into group A (insomnia, N = 78) and group B (without insomnia, N = 221). Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Montreal cognitive assessment (MoCA) were applied to all patients preoperatively. Visual Analogue Scale (VAS) was assessed preoperatively, and at the end of the surgery, one day after surgery, two days after surgery and three days after surgery. The PHQ-9, the GAD-7 and the ISI were reassessed three days after surgery. Information on sociodemographic variables and demographic data were collected.ResultsAmong the two groups, the average points patients got in the ISI, PHQ-9 and the GAD-7 in group A were also significantly higher than those in group B. The VAS score 3 days after surgery was significantly higher in group A. The PHQ-9 and the GAD-7 3 days after surgery showed significantly higher depression and anxiety scores in group A. Logistic regression showed ISI (P < 0.001, 95%CI = 1.218-1.500), the GAD-7 (P = 0.01, 95%CI = 0.712–0.954) preoperatively and the PHQ-9 postoperatively (P < 0.001, 95%CI = 1.226–1.555) were risk factors of insomnia.ConclusionsInsomnia is common in patients, which worsen after surgery. The present study suggests that depression and anxiety are risk factors of poor sleep quality after surgery. There is a need for further research and strategies for depression and anxiety management to achieve better sleep and significant health benefits in these patients.Trial registration: clinical trial, NCT04027751. Registered 22 July 2019, https://clinicaltrials.gov/ct2/show/NCT04027751?cond=NCT04027751&cntry=CN&draw=2&rank=1.

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“…Nevertheless, preliminary research has shown promising results. In one study, traditional CBTi, as well as CBTi with an added mood module both resulted in significant reductions in both insomnia and depression severity compared to a psychoeducation only control group [88]. Simiarly, research examining the effect of a mindfulness-based intervention found that improvements in insomnia symptoms were associated with reductions in depressed mood [89].…”

Section: Emerging Science In the Psychological Treatment Of Late-lifementioning

confidence: 99%

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

Dzierzewski

Griffin

Ravyts

et al. 2018

Curr Sleep Medicine Rep

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Purpose of Review: Late-life insomnia is a serious medical condition associated with many untoward consequences. The high prevalence of late-life insomnia, along with the concomitant risks inherent in the use of hypnotic medications in older adults necessitates non-pharmacological (i.e., psychological) treatment options. We aim to summarize and evaluate the state-of-the-science of psychological treatment options for late-life insomnia. Recent Findings: Cumulative scientific evidence suggests the efficacy of psychological treatment of late-life insomnia. During the previous decade, trials of psychological treatments for insomnia have begun to test various modifications to treatments that have the potential to improve access for older adults, along with expanding their focus to include individuals with comorbid conditions that are common to older adults. While these modifications represent positive advances in the science of treatment for late-life insomnia, the evidence is still largely explanatory/efficacious in nature. Summary: Psychological strategies represent the best approaches for the treatment of late-life insomnia. Future investigations would be wise to progressively move towards increasingly pragmatic/effectiveness investigations, adding to the literature base regarding the treatment of late-life insomnia under usual/real-world conditions as opposed to ideal/artificial conditions.

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Cognitive behavior therapy for older adults with insomnia and depression: a randomized controlled trial in community mental health services

Cited by 70 publications

References 53 publications

The Association of Insomnia with Depression and Anxiety Symptoms in Patients Undergoing Noncardiac Surgery

The Association of Insomnia with Depression and Anxiety Symptoms in Patients Undergoing Noncardiac Surgery

Insomnia is Associated with Depression and Anxiety in Patients Undergoing Noncardiac Surgery

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

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