Epidemiology of Insomnia, Depression, and Anxiety

Taylor, Daniel J.; Lichstein, Kenneth L.; Durrence, H. Heith; Reidel, Brant W; Bush, Andrew

doi:10.1093/sleep/28.11.1457

Cited by 839 publications

(612 citation statements)

References 41 publications

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“…In particular, co-morbidity with mental disorders is very common. People with insomnia are about 10 times more likely to have depression and 17 times more likely to have an anxiety disorder than people without insomnia (Taylor et al 2005). In our study we excluded people with severe anxiety or depressive disorders because the most effective treatment strategy for people with co-morbid insomnia and more severe mental health problems is not known.…”

Section: Discussionmentioning

confidence: 99%

“…Not only is insomnia a significant public health problem in itself, but also many people with insomnia have co-morbid (mental) health problems or will develop co-morbid disorders in the future. Most often reported is the association with depression (Taylor et al 2005;Staner, 2010). In addition, research over the past decade provides increasing evidence that insomnia contributes to the risk of developing heart disease (Redline & Foody, 2011) and is associated with increased mortality (Gallicchio & Kaleson, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

Straten¹,

Emmelkamp²,

Wit³

et al. 2013

Psychol. Med.

114

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Background. Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT delivered through the Internet might be a more accessible alternative. In this study we examined the effectiveness of a guided Internet-delivered CBT for adults with insomnia using a randomized controlled trial (RCT).Method. A total of 118 patients, recruited from the general population, were randomized to the 6-week guided Internet intervention (n = 59) or to a wait-list control group (n = 59). Patients filled out an online questionnaire and a 7-day sleep diary before (T0) and after (T1) the 6-week period. The intervention group received a follow-up questionnaire 3 months after baseline (T2).Results. Almost three-quarters (72.9%) of the patients completed the whole intervention. Intention-to-treat (ITT) analysis showed that the treatment had statistically significant medium to large effects (p < 0.05; Cohen's d between 0.40 and 1.06), and resulted more often in clinically relevant changes, on all sleep and secondary outcomes with the exception of sleep onset latency (SOL) and number of awakenings (NA). There was a non-significant difference in the reduction in sleep medication between the intervention (a decrease of 6.8%) and control (an increase of 1.8%) groups (p = 0.20). Data on longer-term effects were inconclusive.Conclusions. This study adds to the growing body of literature that indicates that guided CBT for insomnia can be delivered through the Internet. Patients accept the format and their sleep improves.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

Straten¹,

Emmelkamp²,

Wit³

et al. 2013

Psychol. Med.

114

View full text Add to dashboard Cite

show abstract

“…All patients who met these criteria were offered bCBTi. Given that people with insomnia are approximately 10 times more likely to be depressed and 17 times more likely to be anxious than those without insomnia, 36 patients with symptoms of anxiety and/or depression were offered bCBTi, unless their symptoms were severe enough to warrant immediate, alternative treatment (e.g., active suicidal ideation or intent, psychosis). Additionally, participants with comorbid medical or psychiatric disorders deemed too severe (e.g., active psychosis) for bCBTi and/or if bCBTi was contraindicated (e.g., active mania, uncontrolled seizures) were not offered treatment.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

McCrae

Bramoweth

Williams

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: To examine health care utilization (HCU) and costs following brief cognitive behavioral treatment for insomnia (bCBTi). Methods: Reviewed medical records of 84 outpatients [mean age = 54.25 years (19.08); 58% women] treated in a behavioral sleep medicine clinic (2005)(2006)(2007)(2008)(2009)(2010) based in an accredited sleep disorders center. Six indicators of HCU and costs were obtained: estimated total and outpatient costs, estimated primary care visits, CPT costs, number of office visits, and number of medications. All patients completed ≥ 1 session of bCBTi. Those who attended ≥ 3 sessions were considered completers (n = 37), and completers with significant sleep improvements were considered responders (n = 32). Results: For completers and responders, all HCU and cost variables, except number of medications, signifi cantly decreased (ps < 0.05) or trended towards decrease at posttreatment. Completers had average decreases in CPT costs of $200 and estimated total costs of $75. Responders had average decreases in CPT costs of $210. No signifi cant decreases occurred for non-completers. Conclusions: bCBTi can reduce HCU and costs. Response to bCBTi resulted in greater reduction of HCU and costs. While limited by small sample size and non-normal data distribution, the fi ndings highlight the need for greater dissemination of bCBTi for several reasons: a high percentage of completers responded to treatment, as few as 3 sessions can result in signifi cant improvements in insomnia severity, bCBTi can be delivered by novice clinicians, and health care costs can reduce following treatment. Insomnia remains an undertreated disorder, and brief behavioral treatments can help to increase access to care and reduce the burden of insomnia. Keywords: Insomnia, health care utilization, costs, brief cognitive behavioral treatment, physician visits, medication Citation: McCrae CS; Bramoweth AD; Williams J; Roth A; Mosti C. Impact of brief cognitive behavioral treatment for insomnia on health care utilization and costs. J Clin Sleep Med 2014;10(2):127-135.http://dx.doi.org/10.5664/jcsm.3436 S C I E N T I F I C I N V E S T I G A T I O N SC hronic insomnia impacts approximately 8% to 10% of adults in the United States population 1 and carries substantial economic burden. Direct costs (i.e., costs directly related to treatment) have been estimated at $13.9 billion annually in the United States, with total treatment costs estimated at $77 to $92 billion. 2 When indirect costs (i.e., lost productivity, insomniarelated accidents, increased medical problems) are included, annual costs exceed $100 billion. 3 Evidence from outside the U.S. reveals a similar pattern. Specifi cally, a study in Quebec, Canada, found that the combined direct and indirect per-person costs of insomnia syndrome (insomnia complaint ≥ 3 nights/ week with > 1 month duration, dissatisfaction with sleep, and daytime impairment; prescription sleep medication ≥ 3 nights/ week) was approximately $5,010; with $293 attributed to direct costs and $4,717...

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“…In the long term, disturbed sleep is associated with a variety of physical and mental health problems, including anxiety and depression (e.g., Irwin et al, 1996;Taylor, Lichstein, Durrence, Reidel, & Bush, 2005).…”

mentioning

confidence: 99%

When Thinking Impairs Sleep: Trait, Daytime and Nighttime Repetitive Thinking in Insomnia

Lancee

Eisma

Zanten

et al. 2015

Behavioral Sleep Medicine

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Epidemiology of Insomnia, Depression, and Anxiety

Cited by 839 publications

References 41 publications

Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

Guided Internet-delivered cognitive behavioural treatment for insomnia: a randomized trial

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

When Thinking Impairs Sleep: Trait, Daytime and Nighttime Repetitive Thinking in Insomnia

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