Rapid Review Quiz: Insomnia Recent Studies

Stephen Soreff, MD; Helmi L. Lutsep, MD

Disclosures

February 14, 2022

Researchers found that CBT-I reduced the likelihood of developing depression by over 50%. In the study, 291 patients (mean age, 70 years; 58% women) with no major depression within the previous 12 months and confirmed insomnia disorder received either CBT-I or sleep education therapy (SET), both delivered for 2 months by trained personnel in weekly 120-minute group sessions, consistent with the duration and format of similar trials.

As a first-line treatment for insomnia, CBT-I comprises five cognitive therapy components that target dysfunctional thoughts about sleep, sleep hygiene, sleep restriction, stimulus control, and relaxation. SET delivers science-based information on environmental and behavioral factors contributing to poor sleep. SET offers tips for improving sleep, whereas CBT-I helps patients implement those tips.

Depression occurred in 25.9% of the SET group vs only 12.2% of the CBT-I group. Compared with the SET group, the hazard ratio (HR) for depression in the CBT-I group was 0.51, and after adjusting for factors affecting depression risk such as comorbidity, educational level, income, sex, and history of depression, the HR for depression in the CBT-I group was 0.45 compared with the SET group.

In total, CBT-I treatment produced an annual 4.1% depression rate, similar to that of the general population and half the SET rate, which was 8.6%. The investigators also found that more patients in the CBT-I group than in the SET group achieved sustained remission of insomnia disorder after treatment (50.7% vs 37.7%; 95% CI, 0.10-0.93; P = .02).

Learn more about CBT and insomnia management.

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