Cognitive Behavioral Therapy for Patients with Primary Insomnia or Insomnia Associated Predominantly with Mixed Psychiatric Disorders: a Randomized Clinical Trial

Edinger, Jack D.; Olsen, Maren K.; Stechuchak, Karen M.; Means, Melanie K.; Lineberger, Margaret D.; Kirby, Angela C.; Carney, Colleen E.

doi:10.1093/sleep/32.4.499

Cited by 238 publications

(187 citation statements)

References 50 publications

Supporting

Mentioning

178

Contrasting

Unclassified

Order By: Relevance

“…Although this is an exploratory study, we speculate that these women might benefit from cognitive behavioral therapy, as demonstrated in studies with non-pregnant participants. [31][32][33] Future research should focus on whether the association between perceived poor sleep quality and adverse birth outcomes that has been found in previous studies is independent or could be explained by co-occurring psychiatric symptoms. Also, the consequences of perceived poor sleep quality during pregnancy for persistence or recurrence of mental disorders in the postpartum period has to be investigated in women with a known mental disorder.…”

Section: Discussionmentioning

confidence: 97%

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Ravesteyn

Tulen

Kamperman

et al. 2014

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Objective: Disturbed sleep during pregnancy is associated with adverse obstetric outcomes and less mental well-being. In pregnant women with a mental disorder, who frequently suffer from sleep problems, it is unknown whether predominantly objective or subjective sleep quality is more affected. To clarify this, we compared objective and subjective parameters of sleep quality between patients and healthy controls during pregnancy. Methods: This observational study was embedded in an ongoing study among pregnant women with a mental disorder at the department of Psychiatry of Erasmus University Medical Center Rotterdam, the Netherlands. We compared 21 pregnant women with a confi rmed mental disorder with 33 healthy controls (gestational age, 23-29 weeks). To measure objective parameters of sleep quality, all participants continuously wore a wrist actigraph for 7 days and nights. Subjective sleep quality was retrospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) and on a daily basis with the Subjective Sleep Quality-scale (SSQ). Differences in parameters of sleep between patients and controls were tested using a multivariate linear regression analysis adjusted for parity, gestational age, educational level, and employment status. Results: Objective parameters of sleep quality and subjective sleep quality as assessed by the PSQI did not differ signifi cantly between patients and controls. Daily sleep reports showed that, relative to controls, patients had a signifi cantly worse average SSQ-score (5.2 vs. 7.6, adjusted β = 0.12, 95%CI = 0.03-0.53, p < 0.01). Conclusions: Our exploratory study suggests that perceived sleep quality reported on a daily basis by pregnant women with a mental disorder is worse than the sleep quality as measured by wrist actigraphy.

show abstract

Section: Discussionmentioning

confidence: 97%

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Ravesteyn

Tulen

Kamperman

et al. 2014

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

show abstract

“…Sleep interventions are effective in both improving sleep in primary insomnia patients, 3,13,45 as well as in patients who are experiencing insomnia and other sleep disturbances comorbid with other disorders. [46][47][48][49][50] Furthermore, preliminary studies suggest that improving sleep quality may also improve symptoms of other physical and mental health disorders associated with insomnia, [51][52][53] further emphasizing the importance of identifying and treating this, and potentially other common sleep disturbances.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

et al. 2011

View full text Add to dashboard Cite

“…35 The score range is from 0-28. Score levels indicate no (0-7), mild clinical insomnia (8)(9)(10)(11)(12)(13)(14), moderate (15)(16)(17)(18)(19)(20)(21), and severe clinical (22)(23)(24)(25)(26)(27)(28) insomnia. We used the continuous, as well as categorical scores, depending on the analyses.…”

Section: Sleep Characteristicsmentioning

confidence: 99%

“…CBT-I has welldocumented benefits, including improvements in insomnia, sleep continuity, and daytime symptoms among patients with a number of comorbid medical conditions. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] CBT-I also may improve sleep for HF patients who dislike the adverse effects of hypnotic medications 12 and are at especially high risk for insomnia and disabling daytime symptoms 34 that are often attributed to HF itself. However, the effects of CBT-I in HF patient have not been examined, and it is not clear that the results of previous studies of CBT-I in people with other chronic medical conditions are generalizable to the HF population.…”

mentioning

confidence: 99%

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

Redeker

Jeon

Andrews

et al. 2015

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Background: Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. Objective: The purpose of this study was to examine the preliminary effi cacy, feasibility, and acceptability of a selfmanagement intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. Methods: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. Results: CBT-I was feasible and acceptable and had a statistically signifi cant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. Conclusions: CBT-I has short-term effi cacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects. Keywords: self-management, heart failure, insomnia, cognitive behavioral therapy, sleep, fatigue, depression Citation: Redeker NS, Jeon S, Andrews L, Cline J, Jacoby D, Mohsenin V. Feasibility and effi cacy of a self-management intervention for insomnia in stable heart failure. J Clin Sleep Med 2015;11(10):1109 -1119 .pii: jc-00335-14 http://dx.doi.org/10.5664/jcsm.5082 H eart failure (HF), a disabling chronic condition that affl icts over fi ve million Americans, 1 is associated with excess morbidity and mortality, comorbidity, poor daytime function, and high symptom burden. Almost 75% of HF patients report poor sleep.2,3 Insomnia, characterized by diffi culty initiating and maintaining sleep, early morning awakenings, non-restorative sleep, and daytime dysfunction, occurs in 25% to 56% of HF patients, 2-5 who report higher rates than "healthy" controls 2 and the general population. Chronic insomnia contributes to incident HF and death. 6 It is distressing and associated with symptoms, such as fatigue, nocturnal dyspnea, depression, anxiety, pain, and excessive daytime sleepiness, poor quality of life, and decrements in functional performance. 3,5,[7][8][9][10][11][12][13] Health care providers frequently attribute sleep disturbance, including insomnia symptoms, to the pathophysiology (e.g., fl uid congestion) and symptoms of HF itself (e.g., nocturnal dyspnea, nocturia) or to sleep disordered breathing that occurs in about half the population.14 However, sleep disordered breathing does not consistently explain insomnia, self-reported sleep quality, or fatigue; and insomnia was closely associated with...

show abstract

Cognitive Behavioral Therapy for Patients with Primary Insomnia or Insomnia Associated Predominantly with Mixed Psychiatric Disorders: a Randomized Clinical Trial

Cited by 238 publications

References 50 publications

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

Contact Info

Product

Resources

About