Assessment and prediction of outcome for a brief behavioral insomnia treatment program

Summary Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive Behavioral Therapy for Insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to (1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, (2) discuss measurement issues, and (3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts.

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“…The mean age ranged from 39.9 34 to 54.2 35 . Only one study focused exclusively on older adults (M=67.96, SD=7.07, range 60–81) 36 .…”

Section: Methodsmentioning

confidence: 99%

Adherence to cognitive behavioral therapy for insomnia: A systematic review

Matthews

Arnedt

McCarthy

et al. 2013

Sleep Medicine Reviews

166

105

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“…SC is one of the most effective single-component therapies for insomnia in adults55,58,59 and has been shown to be effective in multicomponent interventions 55,58,60. SC is based on a functional analysis in which falling asleep by oneself is coupled with reinforcement.…”

Section: Methodsmentioning

confidence: 99%

First effects of a multicomponent treatment for sleep disorders in children

Schlarb¹,

Velten-Schurian²,

Poets³

et al. 2010

NSS

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Insomnia in children is a common disorder, yet only few child-specific treatment modalities exist so far. The goal of this study was to investigate the effectiveness of a multicomponent intervention program for children with insomnia at 5–10 years of age and their parents. The program was a structured six-session behavioral and hypnotherapeutic group treatment with three sessions for the children and three for their parents. Thirty-eight children (5.1–10.9 years) were randomly assigned to the specific treatment condition or waiting list plus sleep diary control condition. Twenty-two children participated in the treatment group and 16 in the control group. All children suffered from insomnia according to the International Classification of Sleep Disorders criteria. Sleep symptoms were assessed with a sleep diary and the German version of the Children Sleep Habit Questionnaire (CSHQ) and the Sleep Disturbance Scale for Children (SDSC). Although both conditions showed a significant decrease in several sleep symptoms, the treatment group exhibited a significantly greater improvement with regard to CSHQ and SDSC total scores as well as in several sleep parameters, reflecting the most important features of the intervention program, such as bedtime, sleep-related anxiety, night waking, and sleeping in parents’ bed. By contrast, the control group’s data revealed only unspecific effects. These pilot data suggest that insomnia in childhood can be treated effectively with this child-specific multicomponent group treatment.

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“…20 Os resultados indicaram uma redução significativa na latência do sono (30 minutos) e no tempo acordado após o início do sono (50 minutos). Estes dados indicam que a combinação entre alguns tipos de terapia comportamental é uma boa opção para o tratamento da insônia.…”

Section: 1220unclassified

Tratamento não farmacológico para a insônia crônica

Passos

Tufik

Santana

et al. 2007

Rev. Bras. Psiquiatr.

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Resumo O objetivo deste artigo é descrever, resumidamente, quais são as terapias não farmacológicas e também a atualização do uso destas para o tratamento da insônia crônica. Além da insônia ser o mais prevalente distúrbio do sono, ela está diretamente associada aos transtornos psiquiátricos. Embora o tratamento farmacológico seja o mais comumente utilizado, as terapias não farmacológicas vêm sendo amplamente estudadas, em particular as relacionadas às mudanças de comportamento. Entre estas estão a cognitiva; a higiene do sono; a do controle de estímulos; a de restrição do sono; a do relaxamento muscular; a da intenção paradoxal e, mais recentemente, a prática regular de exercícios físicos. Inicialmente, o principal objetivo dos estudos realizados com as intervenções comportamentais foi o de melhorar a qualidade do sono dos pacientes. No entanto, alguns estudos recentes têm sido desenvolvidos com o objetivo de avaliar o efeito de tais terapias auxiliando à redução da dose e da freqüência de uso de medicamentos utilizados, bem como à melhora da qualidade de vida dos pacientes. Como a insônia é um problema crônico, os tratamentos de longo prazo têm sido alvos de estudos e de uso comum entre os clínicos.Descritores: Distúrbios do início e manutenção do sono; Sono; Doença crônica; Tratamento; Terapia comportamental A b s t r a c t The purpose of this manuscript is to briefly describe the main modalities of non-pharmacological therapy and its utilization on the chronic insomnia treatment. Insomnia is the most frequent sleep disorder and that is more associated with psychiatry disorders. The pharmacotherapy is the most frequent treatment, but the nonpharmacologic therapy has been studied. The most common therapy modalities include behavioral approaches, stimulus control, sleep restriction, paradoxical intention, sleep hygiene, progressive muscle relaxation and biofeedback and, more recently, physical exercise practices. At first behavioral therapy aimed to improve sleep quality, however, recent studies have been emphasizing the effect of behavioral and cognitive approaches on quality of life, on decrease of dosage and frequency of drugs intake. Since insomnia is a chronic condition, long-term and safe treatments are warranted.

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Assessment and prediction of outcome for a brief behavioral insomnia treatment program

Cited by 43 publications

References 15 publications

Adherence to cognitive behavioral therapy for insomnia: A systematic review

Adherence to cognitive behavioral therapy for insomnia: A systematic review

First effects of a multicomponent treatment for sleep disorders in children

Tratamento não farmacológico para a insônia crônica

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