Monday, July 6, 2015

CBT Reduces Insomnia in Patients With Co-Occurring Psychiatric Conditions

A form of cognitive-behavioral therapy especially developed to treat insomnia (CBT-I) was found to be effective in reducing insomnia symptoms and sleep disturbances, even in cases where the patient has a co-occurring problem such as a psychiatric disorder, according to a new analysis of medical literature published online today in JAMA Internal Medicine.

While a meta-analysis published last month demonstrated that CBT-I—a multicomponent treatment package that usually includes stimulus control, sleep restriction, and cognitive therapy—is a safe and effective treatment option for adults with chronic insomnia, the analysis excluded studies of insomnia comorbid with psychiatric and general medical conditions. For the current study, Jason Ong, Ph.D., of Rush University Medical Center, and colleagues included data from 37 studies and nearly 2,200 participants with insomnia as well as a range of medical conditions (such as depression, alcohol dependence, chronic pain, and cancer).

The researchers found that twice the percentage of patients who received CBT-I achieved remission from insomnia compared with patients in control or comparison groups (36% vs. 17%), and CBT-I improved most sleep parameters with the exception of total sleep time.

CBT-I was also associated with positive effects on the coexisting illness, though the benefits were more pronounced in people with psychiatric disorders compared with other medical problems. The authors suggested this correlation may occur because sleep may be more strongly associated with cognitive-emotional symptoms than physical symptoms.

For more information on sleep and psychiatric disorders, see the Psychiatric News article “Combining Insomnia, Depression Treatment May Improve Outcome” and the FOCUS article “Psychological and Behavioral Treatments for Insomnia,” which was part of an issue devoted to sleep disorders.

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