A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults.

Edinger, Jack D.; Hoelscher, Timothy J.; Marsh, Gail R.; Lipper, Steven; Ionescu-Pioggia, Martin

doi:10.1037/0882-7974.7.2.282

Cited by 95 publications

(68 citation statements)

References 16 publications

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“…Table 2 contains basic details of these studies. One additional multiple baseline study (Edinger, Hoelscher, Marsh, Lipper, & Ionescu-Pioggia, 1992) was also supportive, although effect sizes could not be calculated on the basis of available data; thus, this study's comparison of CBT with relaxation therapy is not included in Table 2.…”

Section: Multicomponent Cbtmentioning

confidence: 99%

Evidence-based psychological treatments for insomnia in older adults.

McCurry¹,

Logsdon²,

Teri³

et al. 2007

Psychology and Aging

142

113

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The review describes evidence-based psychological treatments (EBTs) for insomnia in older adults. Following coding procedures developed by the American Psychological Association's Committee on Science and Practice of the Society for Clinical Psychology, two treatments were found to meet EBT criteria: sleep restriction-sleep compression therapy and multicomponent cognitive-behavioral therapy. One additional treatment (stimulus control therapy) partially met criteria, but further corroborating studies are needed. At the present time, there is insufficient evidence to consider other psychological treatments, including cognitive therapy, relaxation, and sleep hygiene education, as stand-alone interventions beneficial for treating insomnia in older adults. Additional research is also needed to examine the efficacy of alternative-complementary therapies, such as bright light therapy, exercise, and massage. This review highlights potential problems with using coding procedures proposed in the EBT coding manual when reviewing the existing insomnia literature. In particular, the classification of older adults as persons age 60 and older and the lack of rigorous consideration of medical comorbidities warrant discussion in the future.

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Section: Multicomponent Cbtmentioning

confidence: 99%

Evidence-based psychological treatments for insomnia in older adults.

McCurry¹,

Logsdon²,

Teri³

et al. 2007

Psychology and Aging

142

113

View full text Add to dashboard Cite

show abstract

“…Therefore we provide training on the use of worry time and acceptance-based techniques during the day to handle ruminations that might arise in bed, whether they were related to dysfunctional beliefs about sleep or to a tendency to replay past traumatic Dissemination of CBTI natives that involve longer initial TIB. [51][52][53] Although the original SRT method used 4.5 hours as the minimum prescribed sleep opportunity, to ensure patient safety we recommend a 5-h minimum, as recommended by several authors. 54,55 We modified Spielman's original recommended criteria for extending, reducing, or maintaining TIB.…”

Section: Which Comorbidities Other Than Sleep Disorders To Cover and mentioning

confidence: 99%

“…If SE is < 80% and the sleep need is low, there is a 15-min reduction in TIB. The 85% and 80% SE cutoffs we adapted were originally proposed by researchers testing SRT in older adults 51,52,57 and have been subsequently recommended in several therapists' guides. 58,59 Even though the original protocol recommended adjustment every 5 days, 60 we recommend weekly evaluation for adjustments in TIB for pragmatic reasons, since therapy sessions are usually spaced more than 5 days apart.…”

Section: Which Comorbidities Other Than Sleep Disorders To Cover and mentioning

confidence: 99%

“…If napping does not alleviate daytime sleepiness sufficiently to permit the patient to function safely during the day and evening, we recommend relaxing SRT. For example, setting the initial TIB to be average TST plus 30 min 52,63 or using sleep compression, 64 a variant of SRT that involves gradual, rather than abrupt reduction of TIB. These variations of the standard SRT were also recommended for certain frail patients, patients with chronic pain, and patients who respond to SRT with high levels of anxiety.…”

Section: Which Comorbidities Other Than Sleep Disorders To Cover and mentioning

confidence: 99%

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Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Manber

Carney

Edinger

et al. 2012

Journal of Clinical Sleep Medicine

178

124

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Strong evidence supports the effi cacy of cognitive behavioral therapy for insomnia (CBTI). A signifi cant barrier to wide dissemination of CBTI is the lack of qualifi ed practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended). Among these decisions is the question of how to balance the structure and fl exibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

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“…Moreover, the improvements in WASO and SE were maintained through the follow-up period. 69 Another study randomly assigned 24 elderly insomnia patients into a CBTI group and a waiting-list group. Patients in CBTI group improved significantly in subjective measures of WASO, TWT, and SE compared to those in the waiting-list group.…”

Section: Cognitive Restructuringmentioning

confidence: 99%

Management of Late-Life Insomnia

Yang

Lee²,

Yeh

2011

Clinical Medicine Insights: Geriatrics

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Insomnia is a common complaint that can have significant daytime consequences. The prevalence of chronic insomnia may increase with age. The management of late-life insomnia can be complicated because aging is associated with normal changes in sleep structure, continuity, and timing, as well as a higher rate of medical and psychiatric disorders. A thorough evaluation and conceptualization of patients' problems should be conducted for effective treatment planning. Both non-pharmacological and pharmacological strategies have been proven effective in treating insomnia in elderly populations. Behavioral intervention and cognitive behavioral therapy for insomnia are recommended as first considerations. Light therapy may be administered for misalignment of the circadian phase. When necessary, hypnotic medications may be added with adequate safety precautions and consideration of comorbid conditions.

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A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults.

Cited by 95 publications

References 16 publications

Evidence-based psychological treatments for insomnia in older adults.

Evidence-based psychological treatments for insomnia in older adults.

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

Management of Late-Life Insomnia

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