Group cognitive–behavioral therapy in insomnia: a cross-sectional case-controlled study

Abstract

BackgroundGroup cognitive–behavioral therapy (GCBT) might meet the considerable treatment demand of insomnia, but its effectiveness needs to be addressed.ParticipantsThis study recruited 27 insomnia patients treated with 16-weeks of zolpidem (zolpidem group), 26 patients treated with 4-weeks of zolpidem and also treated with 12-weeks of GCBT (GCBT group), and 31 healthy control volunteers.MethodsBefore treatment and 16 weeks after intervention, participants were evaluated using the Patient Health Questionnaires (Patient Health Questionnaire-9 [PHQ-9] and Patient Health Questionnaire-15 [PHQ-15]), the Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16), and the Pittsburgh Sleep Quality Index (PSQI).ResultsCompared to the zolpidem and healthy control groups, the scale scores of PHQ-9, PHQ-15, DBAS-16 and PSQI were significantly reduced after intervention in the GCBT group. Regarding the score changes, there were correlations between PSQI, DBAS-16, PHQ-9, and PHQ-15 scales in the zolpidem group, but there were limited correlations between PSQI and some DBAS-16 scales in the GCBT group.ConclusionOur results indicate that GCBT is effective to treat insomnia by improving sleep quality and reducing emotional and somatic disturbances; thus, the study supports the advocacy of applying group psychotherapy to the disorder.

Does cognitive behaviour therapy for insomnia reduce repetitive negative thinking and sleep-related worry beliefs? A systematic review and meta-analysis

“…Ten out of 15 studies [12,50,73,78e81,84,87,88] included standard CBT-I techniques as treatment. Specifically, 9 included both behavioural (e.g., sleep restriction, stimulus control) and cognitive techniques (e.g., cognitive restructuring) [12,50,73,78,79,81,84,87,88] whilst 1 included behavioural techniques alone [80].…”

“…One study combined individual and self-help therapy within the intervention protocol [90]. Four studies [12,75,78,90] [81,87,88]) or cognitive behaviour therapy for GAD, a treatment specifically targeting worry [73]. With respect to definition and assessment of insomnia, we observed a substantial variability across studies.…”

“…With respect to definition and assessment of insomnia, we observed a substantial variability across studies. Five studies used DSM-5 criteria [12,50,78,81,84] 6 used DSM-IV criteria [14, 73,80,82,87,88] and 1 used DSM-III criteria [79]. Moreover, 2 studies included participants reporting an Insomnia Severity Index score equal to 15 or higher [75,90] and 1 study [89] included participants reporting a score higher than 5 on the Pittsburgh sleep quality index (PSQI).…”

“…Additionally, with respect to comorbidities: 7 out of 15 studies [12,79,81,82,84,87,88] included participants without severe mental, sleep or physical comorbidity associated with insomnia. Several trials targeted exclusively individuals with specific comorbidities, including GAD [73,89], cancer [80,90], and depressive symptoms [50].…”