Effects of Brief Cognitive Behavioral Therapy for Insomnia on Improving Depression Among Community‐Dwelling Older Adults: A Randomized Controlled Comparative Study

Abstract

Background: Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve depressive symptoms in older adults with comorbid insomnia and depression. However, it remains unclear whether brief CBT-I is effective for improving depressive symptoms in communitydwelling older adults with insomnia symptoms of varying severity.Aim: This study sought to examine the effectiveness of a brief CBT-I intervention delivered by public health nurses to improve depressive symptoms among older adults recruited from a community setting.Methods: This randomized controlled study compared sleep status and depression at baseline and a 3-month follow-up using a wait-list control design. Depression was evaluated using the Geriatric Depression Scale short form (GDS-SF). Results: The GDS-SF scores in the CBT-I group improved over time (p < .01), with an effect size (Cohen's d) of 0.34 (95% CI [0.16, 0.58]). The results demonstrated the effectiveness of a brief CBT-I intervention for depression, although the effect size was small.Linking Evidence to Action: A brief CBT-I intervention consisting of sleep hygiene education, stimulus control, sleep restriction, cognitive restructuring, and relaxation is effective for improving depressive symptoms among older adults in the community.

Effects of an internet-delivered insomnia intervention for older adults: A secondary analysis on symptoms of depression and anxiety

“…In terms of studies of CBT-I among older adults, there are two smaller-scale studies that report effects of face-to-face CBT-I on mood outcomes. These also demonstrated significant reductions in depressive symptoms among older participants receiving CBT-I (Sadler et al, 2018 ; Tanaka et al, 2019 ); however, there was a marked difference in effect sizes between trials. In the first trial, Sadler and colleagues ( 2018 ) included older adults with comorbid insomnia and major depression and demonstrated a large effect of CBT-I on depressive symptoms relative to a patient education control group (Sadler et al, 2018 ), and also found significant reductions in anxiety among those receiving CBT-I but not patient education.…”

“…In the first trial, Sadler and colleagues ( 2018 ) included older adults with comorbid insomnia and major depression and demonstrated a large effect of CBT-I on depressive symptoms relative to a patient education control group (Sadler et al, 2018 ), and also found significant reductions in anxiety among those receiving CBT-I but not patient education. In the second trial, Tanaka and colleagues ( 2019 ) enrolled older adults with insomnia without requiring significant depressive symptoms and demonstrated a small effect of CBT-I relative to wait-list control on depressive symptoms; they did not report findings related to anxiety (Tanaka et al, 2019 ). Differences between our study and these two trials of face-to-face CBT-I may be due in part to the nature of fully-automating delivery of CBT-I without clinical contact.…”

Nemigos Nemedikamentinis Gydymas

“…Terapija orientuota į du fiziologinius procesus: homeostatinį ir cirkadinį polinkį. Pacientai mokomi keisti savo miego įpročius ir elgesį [23]. Naujausių tyrimų duomenimis nustatyta, kad trumpalaikė elgesio terapija veiksmingai mažina nemigos simptomus ir daugeliu atveju sukelia nemigos remisiją [22].…”

Intervención psicológica en trastornos del sueño: una revisión actualizada

“…El grueso de la literatura pone de manifiesto que la Terapia Cognitivo Conductual es un tratamiento válido para el manejo del insomnio (Geiger-Brown et al, 2015;Traueret al, 2015) derivado de ello se han comenzado a mejorar los protocolos, obteniendo formatos abreviados de 4 sesiones (Pigeon et al, 2017;Tanaka et al, 2019) y manejo basado en internet, (Luyster et al, 2020;Moloney et al, 2019;) obteniendo resultados similares a los tratamientos convencionales lo que ayuda a la disminución en el costo de la intervención.…”