The Impact of Cognitive-Behavioral Interventions on Sleep Disturbance in Depressed and Anxious Community-dwelling Older Adults: A Systematic Review

Abstract

Introduction: Depression and anxiety are prevalent mental health conditions in older adulthood. Despite sleep disturbance being a common comorbidity in late-life depression and anxiety, it is often discounted as a target for treatment. The current review aims to establish whether cognitive-behavioral therapy (CBT) is effective in treating concomitant sleep disturbance in depressed and anxious older adults and to review evidence supporting whether CBT interventions targeting anxiety and depression, or concurrent sleep disturbance, have the greatest effectiveness in this client group. Method: A systematic database search was conducted to identify primary research papers evaluating the effectiveness of CBT interventions, recruiting older adults with symptoms of depression and/or anxiety, and employing a validated measure of sleep disturbance. The identified papers were included in a narrative synthesis of the literature. Results: Eleven identified studies consistently support reductions in sleep disturbance in elderly participants with depression and anxiety in response to CBT. Most CBT interventions in the review included techniques specifically targeting sleep, and only one study directly compared CBT for insomnia (CBT-I) with a CBT-I intervention also targeting depressive symptoms, limiting the ability of the review to comment on whether interventions targeting sleep disturbance or mental health symptoms have superior effectiveness. Conclusion:The extant research indicates that CBT interventions are effective in ameliorating sleep disturbance in late-life depression and anxiety. Future high-quality research is required to substantiate this finding and to compare the effectiveness of CBT-I and CBT for depression and anxiety in this group to inform clinical practice.

Comparative efficacy of non‐pharmacological interventions on sleep quality in old adults: A systematic review and network meta‐analysis

“…It consists of cognitive therapy, sleep hygiene education, sleep restriction therapy and, sleep stimulation therapy. The results are consistent with the findings of Bentham and Eaves, (2022), who noted that cognitive behavioural therapy not only improves the quality of sleep in older people, but also helps to reduce anxiety and depression. A meta‐analysis by Zhang et al.…”

“…It consists of cognitive therapy, sleep hygiene education, sleep restriction therapy and, sleep stimulation therapy. The results are consistent with the findings ofBentham and Eaves, (2022), who noted that cognitive behavioural therapy not only improves the quality of sleep in older people, but also helps to reduce anxiety and depression. A meta-analysis byZhang et al (2022) also showed that scognitive behavioural therapy improved the quality of sleep in insomnia patients and was more effective than other therapies such as medication and psychotherapy.…”

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