CBT-I and HT-I group therapy for adults with insomnia in comparison to those with insomnia and comorbid depression – a pilot study

Abstract

PurposeThe aim of this study was to examine the effectiveness of a combined cognitive-behavioral therapy for insomnia (CBT-I) and hypnotherapy for insomnia (HT-I) program for insomnia patients with or without additional depression regarding depressive symptoms and various sleep parameters.Patients and methodsA sample of 63 patients suffering from insomnia received a six-session sleep intervention, which combined cognitive-behavioral and hypnotherapeutical elements. Due to violating exclusion criteria, data of 37 patients were analyzed. Ten patients had insomnia comorbid with depression, whereas 27 patients had insomnia only. Sleep diaries were implemented to measure various sleep parameters, whereas depressive symptomatology was assessed with the anxiety and depression scale and Symptom-Checklist-90-R at baseline, before and after the intervention, as well as at 3-months follow-up.ResultsDepressive symptoms decreased from pre to post measurement and follow-up for patients with insomnia comorbid with depression, whereas scores of patients with only insomnia remained relatively on a low level. Both groups showed a significant increase of sleep efficiency and a significant decrease of the duration of wake after sleep onset. However, only patients with insomnia and depression revealed a significant reduction of sleep-onset latency and a higher level of regeneration. Nondepressive insomniacs, on the other hand, showed a significant increase of performance from post measurement to follow-up. For both groups, no change over time was found for number of wake after sleep onset, total sleep time, mood in the morning and evening.ConclusionCombining CBT-I and HT-I is effective in reducing depressive symptoms and improving sleep. Therefore, nonresponders to other forms of therapy, eg, pharmacological, interpersonal, or cognitive-behavioral therapy, might benefit from the combined CBT-I/HT-I intervention.

Modularized iCBT‑I self-learn training for university staff—prevention and early intervention in the SARS-CoV-2 crisis

“…Most participants reached clinically significant changes. Furthermore, insomnia symptoms decreased—especially sleep onset latency and sleep quality which is also reported by face-to-face treatment effects [ 21 ]. According to the participants’ feedback, the theoretical and practical knowledge was comprehensible.…”

“…The original CBT‑I program was created for chronic insomnia disorder and nightmare disorder based on ICD-10, DSM‑5 or ICSD‑3 criteria [ 17 , 19 ]. Contents of the CBT‑I were formalized in a manual [ 17 ] and effects for insomnia population also with comorbid depression was published [ 18 , 21 ]. For a more detailed description of the treatment components see Schlarb (in press) [ 17 ].…”

“…Therefore, the objective of the current study was to develop, implement and examine the acceptance, adherence and efficacy of an iCBT‑I prevention and early intervention self-learning training for sleep problems in university staff. Based on previous studies addressing insomnia in adults [ 21 ], we wanted to adapt the structured CBT‑I manual to an iCBT‑I prevention and early treatment training. Adaptation procedure, construction of modules with their contents, and videos and exercises will be described precisely, and acceptance as well as first effects will be evaluated in this pilot study.…”

The E2R (Emotion, regression, repair) method: A case study of this new pragmatic hypnotherapy technique

“…Suggestions of pleasant experiences [10], thermal sensation arousal [11,12], visualization of a safe place [13,14], and number-counting focus [6,15] are also offered to insomniac patients. These hypnotic techniques sometimes incorporate cognitive behavioral therapy (CBT) techniques [10,16] or may combine hypnosis and CBT [17,18]. Age regression techniques such as the affect bridge [19], as well as that around age progression [20] use the flexibility of hypnosis to cross time lines more quickly.…”