CBT for insomnia in patients with high and low depressive symptom severity

Adherence and clinical outcomes

Rachel Manber, Rebecca A. Bernert, Sooyeon Suh, Sara Nowakowski, Allison T. Siebern, Jason C. Ong

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Study Objectives: To evaluate whether depressive symptom severity leads to poorer response and perceived adherence to cognitive behavioral therapy for insomnia (CBTI) and to examine the impact of CBTI on well-being, depressive symptom severity, and suicidal ideation. Design: Pre- to posttreatment case replication series comparing low depression (LowDep) and high depression (HiDep) groups (based on a cutoff of 14 on the Beck Depression Inventory [BDI]). Participants: 127 men and 174 women referred for the treatment of insomnia. Interventions: Seven sessions of group CBTI. Measurements and Results: Improvement in the insomnia severity, perceived energy, productivity, self-esteem, other aspects of wellbeing, and overall treatment satisfaction did not differ between the HiDep and LowDep groups (p > 0.14). HiDep patients reported lower adherence to a fixed rise time, restricting time in bed, and changing expectations about sleep (p < 0.05). HiDep participants experienced significant reductions in BDI, after removing the sleep item. Levels of suicidal ideation dropped significantly among patients with pretreatment elevations (p < 0.0001). Conclusion: Results suggest that pre- to post CBTI improvements in insomnia symptoms, perceived energy, productivity, self-esteem, and other aspects of well-being were similar among patients with and without elevation in depressive symptom severity. Thus, the benefits of CBTI extend beyond insomnia and include improvements in non-sleep outcomes, such as overall well-being and depressive symptom severity, including suicidal ideation, among patients with baseline elevations. Results identify aspects of CBTI that may merit additional attention to further improve outcomes among patients with insomnia and elevated depressive symptom severity.

Original languageEnglish (US)
Pages (from-to)645-652
Number of pages8
JournalJournal of Clinical Sleep Medicine
Volume7
Issue number6
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Sleep Initiation and Maintenance Disorders
Depression
Cognitive Therapy
Suicidal Ideation
Self Concept
Sleep
Equipment and Supplies

Keywords

  • CBTI
  • Depression
  • Insomnia
  • Nonpharmacological treatment
  • Suicide ideation

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

CBT for insomnia in patients with high and low depressive symptom severity : Adherence and clinical outcomes. / Manber, Rachel; Bernert, Rebecca A.; Suh, Sooyeon; Nowakowski, Sara; Siebern, Allison T.; Ong, Jason C.

In: Journal of Clinical Sleep Medicine, Vol. 7, No. 6, 2011, p. 645-652.

Research output: Contribution to journalArticle

Manber, Rachel ; Bernert, Rebecca A. ; Suh, Sooyeon ; Nowakowski, Sara ; Siebern, Allison T. ; Ong, Jason C. / CBT for insomnia in patients with high and low depressive symptom severity : Adherence and clinical outcomes. In: Journal of Clinical Sleep Medicine. 2011 ; Vol. 7, No. 6. pp. 645-652.
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