Disseminating Cognitive-Behavioral Therapy for Insomnia

This therapy, delivered by telephone, is more effective than an informational pamphlet.

Chronic insomnia is common and associated with adverse health effects, lost productivity, lower quality of life, and heightened risk for psychiatric and substance use disorders. Although effective, cognitive-behavioral therapy for insomnia (CBT-I) is time-intensive and costly. In a randomized, controlled study involving 30 people with chronic insomnia (3 men; age range, 18–65; none taking prescription sleep medications), researchers examined the efficiency and effectiveness of delivering CBT-I by telephone. The control condition used the American Academy of Sleep Medicine's informational pamphlet, Cognitive-Behavioral Therapy for Insomnia.

Individuals with poorly controlled axis I psychiatric or medical disorders were excluded. Telephone-delivered CBT-I consisted of four to eight weekly sessions, each lasting 15 to 60 minutes, with an experienced therapist. Control participants were mailed the pamphlet and received one 15- to 20-minute telephone session with a therapist who reviewed the pamphlet without giving individualized recommendations.

At posttreatment and at 12-week follow-up, both groups improved significantly in sleep efficiency, total sleep time, and daytime functioning, based on sleep/wake diaries. CBT-I yielded a higher rate of remission at 12 weeks than the control condition (80% vs. 42%; number needed to treat, 2.6) and greater reduction in dysfunctional beliefs about sleep.

CITATION(S):

Arnedt JT et al. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. Sleep 2013 Mar 1; 36:353. 

Sivertsen B et al. The future of insomnia treatment — the challenge of implementation. Sleep 2013 Mar 1; 36:303.