BALTIMORE—Cognitive behavioral therapy for insomnia (CBTI), whether administered in group or individual sessions, was associated with improved self-reported sleep quality among older veterans, compared with an informational sleep program, according to a study presented at the 27th Annual Meeting of the Associated Professional Sleep Societies.
After completion of the individual CBTI program, participants’ scores on the Pittsburgh Sleep Quality Index (PSQI) improved by 3.2 points, compared with baseline, said Jennifer L. Martin, PhD. At the end of the group CBTI program, participants’ PSQI scores improved by 3.5 points, compared with baseline. PSQI scores changed little for subjects who had attended the informational program, said Dr. Martin, Adjunct Associate Professor of Medicine at the David Geffen School of Medicine at UCLA.
Dr. Martin and her colleagues conducted a randomized controlled trial to test the effectiveness of a five-session CBTI program for older veterans. The researchers used a survey to enroll 519 veterans older than 60. Eligible participants had insomnia according to the International Classification of Sleep Disorders-2.
A total of 168 respondents were randomized to individual CBTI, CBTI in groups of three to five participants, or an informational control group. Unlike subjects randomized to CBTI, controls received no individualized recommendations. Participants filled out questionnaires and underwent one week of wrist actigraphy with a sleep diary at baseline, immediately after treatment, six months after treatment, and one year after treatment. PSQI scores were similar at baseline for the two CBTI groups and the control group. At six months follow-up, patients who had undergone individual or group CBTI had significantly greater improvements in PQSI score than controls. “The individuals who received CBTI were still doing better than the control group a full year after treatment with no additional intervention,” said Dr. Martin.
The investigators found a similar pattern of results for the Insomnia Severity Index (ISI). Subjects who had undergone group or individual CBTI had significant improvements in ISI immediately after treatment, at six months, and at 12 months follow-up.
“The fact that we saw consistent gains that were maintained over time is promising,” said Dr. Martin. “This model for delivering CBTI may improve access in settings where a behavioral sleep medicine specialist is not readily available, but might be able to train and supervise allied health personnel,” she concluded.
—Erik Greb
Senior Associate Editor