Rapid Review Quiz: Insomnia Recent Studies

Stephen Soreff, MD; Helmi L. Lutsep, MD


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.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.