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Treating acute insomnia: A randomized controlled trial of a "single-shot" of cognitive behavioral therapy for insomnia

Lookup NU author(s): Professor Jason Ellis

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Abstract

© 2015, Associated Professional Sleep Societies, LLC. All rights reserved. Study Objectives: Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia. Design: A pragmatic parallel group randomized controlled trial. Setting: Community. Participants: Forty adults (mean age 32.9 ± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep. Interventions: A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects were offered a full individual course of CBT-I on completion of the study, regardless of group allocation. Measurements and Results: Subjects completed sleep diaries and the Insomnia Severity Index (ISI) pretreatment and 1 mo following treatment. There were no between-group differences on baseline ISI scores or subjective sleep continuity. The intervention group reported significantly lower ISI scores than controls (t(38) 2.24, P < 0.05) at follow-up. Further, using proposed ISI scores for identifying insomnia caseness (i.e., ≥ 10), 60% of those in the CBT-I group had remitted by 1 mo compared to 15% of those in the control group. Conclusions: This single session of cognitive behavioral therapy for insomnia (CBT-I) is sufficiently efficacious for a significant proportion of those with acute insomnia. The results are discussed in terms of integrating this brief form of CBT-I into the "stepped care" model of insomnia. Trial Registration: Testing the efficacy of an early intervention for acute insomnia (SRCTN05891695) http://www.controlled-trials.com/ ISRCTN05891695.

Publication metadata

Author(s): Ellis JG, Cushing T, Germain A

Publication type: Article

Publication status: Published

Journal: Sleep

Year: 2015

Volume: 38

Issue: 6

Pages: 971-978

Print publication date: 01/06/2015

Acceptance date: 01/11/2014

ISSN (print): 0161-8105

ISSN (electronic): 1550-9109

Publisher: Associated Professional Sleep Societies,LLC

URL: https://doi.org/10.5665/sleep.4752

DOI: 10.5665/sleep.4752

PubMed id: 25515106

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