Cognitive Behavioral Therapy for Chronic Insomnia in Outpatients with Major Depression—A Randomised Controlled Trial

Abstract

The aim of this randomised controlled assessor-blinded trial was to examine the effect of cognitive behavioural therapy for insomnia on sleep variables and depressive symptomatology in outpatients with comorbid insomnia and moderate to severe depression. Forty-seven participants were randomized to receive one weekly session in 6 weeks of cognitive behavioural therapy for insomnia or treatment as usual. The intervention was a hybrid between individual and group treatment. Sleep scheduling could be especially challenging in a group format as patients with depression may need more support to adhere to the treatment recommendations. The primary outcome measure was the Insomnia Severity Index. Secondary measures were sleep diary data, the Dysfunctional Beliefs and Attitudes about Sleep Questionnaire, the Hamilton Depression Rating Scale, and the World Health Organization Questionnaire for Quality of Life and polysomnography. Compared to treatment as usual, cognitive behavioural therapy significantly reduced the insomnia severity index (mean ISI 20.6 to 12.1, p = 0.001) and wake after sleep onset (mean 54.7 min to 19.0 min, p = 0.003) and increased sleep efficiency (mean SE 71.6 to 83.4, p = 0.006). Total sleep time and sleep onset latency were not significantly changed. The results were supported by analyses of the other rating scales and symptom dimensions. In conclusion, cognitive behavioural therapy for insomnia as add-on to treatment as usual was effective for treating insomnia and depressive symptoms in a small sample of outpatients with insomnia and major depression. ClinicalTrials.gov Identifier: NCT02678702.

Sleep disturbance and medical requests among university and college students in Chongqing, China

“…37 In our study, university and college students with sleep disturbance tend to choose cognitive behavioral therapy accounted for 34.68%, higher than drug therapy and other treatments, which has proved to be helpful for students to change the usefulness cognitive and behavioral patterns of quality sleep and be superior to medication and produces longer-lasting positive effects. 38,39 The possible reason for the outcome is that university and college students' sleep disturbance are mainly related to bad sleep environment, unhealthy lifestyle, or incorrect concept of sleep, therefore, the cognitive behavior therapy can help them improve the situation.…”