One-week Inpatient Cognitive Behavioral Therapy for Insomnia: a Retrospective Study

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2024 Sep 11

PMID 39257560

Authors

Qing Cai

Mengya Li

Guifeng Li

Xin Xu

Cheng Li

Qifang Li

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the effectiveness of one-week inpatient cognitive behavioral therapy for insomnia (CBT-I) in patients without severe mental disorders in the real-world setting to answer the research question "Can inpatient CBT-I be abbreviated?".

Methods: In this retrospective, single-group, pretest-posttest study, the clinical outcome data of 94 patients who underwent one-week inpatient CBT-I were collected. Self-report scale scores and hypnotic medication use were obtained at baseline and at the 3-month follow-up after therapy.

Results: CBT-I significantly improved insomnia severity ( = -7.65, < 0.001, Cohen's 1.34), anxiety ( = -6.23, < 0.001, Cohen's 1.02), depression ( = -6.42, < 0.001, Cohen's 1.06), daytime sleepiness ( = -2.40, = 0.016, Cohen's 0.35), and fatigue severity ( = -5.54, < 0.001, Cohen's 0.88) and reduced hypnotic medication use ( = 33.62, < 0.001). At the follow-up assessment, 58 patients (67.4%) had clinically meaningful changes in insomnia, and 51 patients (59.3%) met the criteria for insomnia remission.

Conclusion: The results of this preliminary study imply that one-week inpatient CBT-I may be an effective intervention for the treatment of insomnia in patients without severe mental disorders.

References

Ohayon M . Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2003; 6(2):97-111. DOI: 10.1053/smrv.2002.0186. View

Espie C . "Stepped care": a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment. Sleep. 2010; 32(12):1549-58. PMC: 2786038. DOI: 10.1093/sleep/32.12.1549. View

Schneider C, Hertenstein E, Nissen C . Cognitive behavioural therapy for insomnia in inpatient psychiatric care: a systematic review. J Sleep Res. 2023; 32(6):e14041. DOI: 10.1111/jsr.14041. View

Kallestad H, Scott J, Vedaa O, Lydersen S, Vethe D, Morken G . Mode of delivery of Cognitive Behavioral Therapy for Insomnia: a randomized controlled non-inferiority trial of digital and face-to-face therapy. Sleep. 2021; 44(12). PMC: 8664599. DOI: 10.1093/sleep/zsab185. View

Cronlein T, Langguth B, Geisler P, Wetter T, Eichhammer P . Fourteen-day inpatient cognitive-behavioural therapy for insomnia: a logical and useful extension of the stepped-care approach for the treatment of insomnia. Psychother Psychosom. 2014; 83(4):255-6. DOI: 10.1159/000360706. View

Zigmond A, SNAITH R . The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x. View

Vincent N, Walsh K . Stepped care for insomnia: an evaluation of implementation in routine practice. J Clin Sleep Med. 2013; 9(3):227-34. PMC: 3578678. DOI: 10.5664/jcsm.2484. View

Perils M, Smith M . How can we make CBT-I and other BSM services widely available?. J Clin Sleep Med. 2008; 4(1):11-3. PMC: 2276824. View

Stenberg J, Ritola V, Joffe G, Saarni S, Rosenstrom T . Effectiveness of mobile-delivered, therapist-assisted cognitive behavioral therapy for insomnia in nationwide routine clinical care in Finland. J Clin Sleep Med. 2022; 18(11):2643-2651. PMC: 9622989. DOI: 10.5664/jcsm.10186. View

10.

Johns M . A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14(6):540-5. DOI: 10.1093/sleep/14.6.540. View

11.

Bramoweth A, Lederer L, Youk A, Germain A, Chinman M . Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans. Behav Ther. 2020; 51(4):535-547. PMC: 10352919. DOI: 10.1016/j.beth.2020.02.002. View

12.

Chen Y, Lu T, Ku E, Chen C, Fang C, Lai P . Efficacy of brief behavioural therapy for insomnia in older adults with chronic insomnia: a systematic review and meta-analysis from randomised trials. Age Ageing. 2023; 52(1). DOI: 10.1093/ageing/afac333. View

13.

Morin C, Vallieres A, Guay B, Ivers H, Savard J, Merette C . Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009; 301(19):2005-15. PMC: 3050624. DOI: 10.1001/jama.2009.682. View

14.

Okun M, Glidewell R . Improvement of Insomnia Symptoms following a Single 4-Hour CBT-I Workshop. Behav Sleep Med. 2022; 21(1):72-83. DOI: 10.1080/15402002.2022.2036741. View

15.

Gao Y, Ge L, Liu M, Niu M, Chen Y, Sun Y . Comparative efficacy and acceptability of cognitive behavioral therapy delivery formats for insomnia in adults: A systematic review and network meta-analysis. Sleep Med Rev. 2022; 64:101648. DOI: 10.1016/j.smrv.2022.101648. View

16.

Sun M, Zhou H, Li Y, Wang J, Yang W, Gong Y . Professional characteristics, numbers, distribution and training of China's mental health workforce from 2000 to 2020: a scoping review. Lancet Reg Health West Pac. 2024; 45:100992. PMC: 11064725. DOI: 10.1016/j.lanwpc.2023.100992. View

17.

Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J . Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019; 6(3):211-224. DOI: 10.1016/S2215-0366(18)30511-X. View

18.

Vedaa O, Hagatun S, Kallestad H, Pallesen S, Smith O, Thorndike F . Long-Term Effects of an Unguided Online Cognitive Behavioral Therapy for Chronic Insomnia. J Clin Sleep Med. 2019; 15(1):101-110. PMC: 6329541. DOI: 10.5664/jcsm.7580. View

19.

Simon L, Steinmetz L, Feige B, Benz F, Spiegelhalder K, Baumeister H . Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis. Sci Rep. 2023; 13(1):1929. PMC: 9894949. DOI: 10.1038/s41598-023-28853-0. View

20.

Griffiths F, Lindenmeyer A, Powell J, Lowe P, Thorogood M . Why are health care interventions delivered over the internet? A systematic review of the published literature. J Med Internet Res. 2006; 8(2):e10. PMC: 1550698. DOI: 10.2196/jmir.8.2.e10. View