National Institutes of Health State of the Science Conference Statement

Patrick, Daniel L.; Ferketich, Sandra; Frame, Paul; Harris, Jesse J.; Hendricks, Carolyn B.; Levin, Barbara C.; Link, Michael P.; Lustig, Craig; McLaughlin, Joseph M.; Reid, Lindsay Ann; Turrisi, Andrew T.; Unützer, Jürgen; Vernon, Sally W.

doi:10.1093/sleep/28.9.1049

Cited by 593 publications

(133 citation statements)

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“…Chronic insomnia is a significant public health problem due to its high prevalence [1,2,3], and its association with disability, function impairment and high utilisation of health services [4,5,6,7,8,9]. Current pharmaceutical treatments have limitations due to the presence of side effects and the potential for dependence and withdrawal [10].…”

Section: Introductionmentioning

confidence: 99%

Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

Wong

Zhang

et al. 2017

Psychother Psychosom

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Background: Mindfulness-based cognitive therapy (MBCT) is a potential treatment for chronic insomnia. We evaluated the efficacy of MBCT for insomnia (MBCT-I) by comparing it with a sleep psycho-education with exercise control (PEEC) group. Methods: Adults with chronic primary insomnia (n = 216) were randomly allocated to the MBCT-I or PEEC group. The MBCT-I included mindfulness and psycho-education with cognitive and behavioural components under cognitive behavioural therapy for insomnia. PEEC included psycho-education of sleep hygiene and stimulus control, and exercises. Any change in insomnia severity was measured by the Insomnia Severity Index (ISI). Secondary outcomes included sleep parameters measured by a sleep diary, health service utilisation, absence from work and mindfulness measured by the Five Facet Mindfulness Questionnaire. Results: The ISI score significantly decreased in the MBCT-I group compared with the PEEC group at 2 months (i.e., post-intervention) (p = 0.023, effect size [95% CI] -0.360 [-0.675, -0.046]) but not at 5 or 8 months. Treatment response rates and remission rates based on the ISI cut-off scores were not significantly different between groups. Wake time after sleep onset (WASO) was less in the MBCT-I group at 2 and 5 months. At 8 months, both groups showed a reduced ISI score, sleep onset latency and WASO, and increased sleep efficiency and total sleep time; however, no group differences were seen. Other outcome measures did not significantly improve in either group. Conclusions: Long-term benefits were not seen in MBCT-I when compared with PEEC, although short-term benefits were seen.

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Section: Introductionmentioning

confidence: 99%

Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

Wong

Zhang

et al. 2017

Psychother Psychosom

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“…Yet, the vast majority of the research, theory, and treatment evidence focuses on night time symptoms and processes (Riedel & Lichstein, 2000). Moreover, there is very limited evidence that insomnia treatment improves daytime functioning, psychological well-being, and quality of life (NIH, 2005). This is an important gap in knowledge given that it has typically been assumed that treatments for insomnia that address sleep will also effectively address daytime impairment but the limited data currently available are equivocal.…”

mentioning

confidence: 99%

Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: A randomized controlled trial.

Harvey

Bélanger

Talbot

et al. 2014

Journal of Consulting and Clinical Psychology

172

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Objective To examine the unique contribution of behavior therapy (BT) and cognitive therapy (CT) relative to the full cognitive behavior therapy (CBT) for persistent insomnia. Method Participants were 188 adults (117 women; M age = 47.4 years old, SD=12.6) with persistent insomnia (average of 14.5 years duration). They were randomized to eight, weekly, individual sessions consisting of BT (n = 63), CT (n = 65), or CBT (n = 60). Results Full CBT was associated with greatest improvements, the improvements associated with BT were faster but not as sustained and the improvements associated with CT were slower and sustained. The proportion of treatment responders was significantly higher in the CBT (67.3%) and BT (67.4%) relative to CT (42.4%) groups at post treatment, while 6-months later CT made significant further gains (62.3%), BT had significant loss (44.4%) and CBT retained its initial response (67.6%). Remission rates followed a similar trajectory, with higher remission rates at post treatment in CBT (57.3%) relative to CT (30.8%), with BT falling in between (39.4%); CT made further gains from post treatment to follow up (30.9% to 51.6%). All three therapies produced improvements of daytime functioning at both post treatment and follow up, with few differential changes across groups. Conclusions Full CBT is the treatment of choice. Both BT and CT are effective, with a more rapid effect for BT and a delayed action for CT. These different trajectories of changes provide unique insights into the process of behavior change via behavioral versus cognitive routes.

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“…Secondary treatment includes antidepressants, diphenhydramine, antipsychotics, and barbiturates [4]. Although effective, these medications often cause side effects such as residual daytime sedation, drowsiness, dizziness, lightheadedness, cognitive impairment, motor incoordination, and dependence [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of acupuncture on patients with insomnia: study protocol for a randomized controlled trial

Han

Kim

Chung

2014

Trials

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BackgroundHypnotic drugs tend to be the dominant form of treatment of insomnia, but these come with a number of reported side effects. Acupuncture has been studied as an alternative, resulting in a rising need for methodological research towards verifying its efficacy as insomnia treatment.Methods/DesignWe describe a proposal for a single-center, patient-assessor-blinded, randomized controlled trial with two parallel arms. A total of 38 patients complete screening tests at the first visit, are registered into the clinical trial, and then randomly assigned to the experimental or sham control groups (19 patients for each group). All subjects are clinical insomnia patients who score a 6 or above on the Pittsburgh Sleep Quality Index (PSQI) and meet all inclusion criteria. All subjects are treated with acupuncture and intradermal acupuncture (IDA) three times during the first week. Five sham acupoints are used in the control group. In the experimental group, five real acupoints (PC6, SP6, HT7, KI6, and BL62) are used unilaterally in turn. Sham acupoints are over 1 cm away from each real acupoint.The primary outcomes are the scores on the Insomnia Severity Index (ISI) and PSQI. Secondary outcomes are the sleep log, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF), the Korean-Auditory Verbal Learning Test (K-AVLT), the Digit Span Test (DS), Event Related Potentials (ERPs) and heart rate variability (HRV) to assess emotional states, sleep quality, cognitive functioning, and electro-physiological changes.Subjects are assessed at three time points: baseline, post-treatment and follow-up. The duration of the clinical trial is 18 days.DiscussionTo study the enhancement of the effectiveness of acupuncture for insomnia, we test the intradermal acupuncture method, which is performed continuously on the subject’s skin and stimulated at home by the subject every night. In the trial, objective measurements including ERPs and HRV are used to evaluate states of cognition and autonomic nervous system functioning and subjective self-report questionnaires assess insomnia symptoms.'Sham’ acupuncture points provided by STRICTA are used for the control group.Trial registrationClinicalTrials.gov: NCT01956760, registered 5 September 2013.

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National Institutes of Health State of the Science Conference Statement

Cited by 593 publications

References 0 publications

Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: A randomized controlled trial.

Effect of acupuncture on patients with insomnia: study protocol for a randomized controlled trial

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