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 language | English (US) |
|---|---|
| Pages (from-to) | 645-652 |
| Number of pages | 8 |
| Journal | Journal of Clinical Sleep Medicine |
| Volume | 7 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2011 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - CBT for insomnia in patients with high and low depressive symptom severity
T2 - Adherence and clinical outcomes
AU - Manber, Rachel
AU - Bernert, Rebecca A.
AU - Suh, Sooyeon
AU - Nowakowski, Sara
AU - Siebern, Allison T.
AU - Ong, Jason C.
PY - 2011
Y1 - 2011
N2 - 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.
AB - 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.
KW - CBTI
KW - Depression
KW - Insomnia
KW - Nonpharmacological treatment
KW - Suicide ideation
UR - http://www.scopus.com/inward/record.url?scp=84855708021&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855708021&partnerID=8YFLogxK
U2 - 10.5664/jcsm.1472
DO - 10.5664/jcsm.1472
M3 - Article
VL - 7
SP - 645
EP - 652
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
SN - 1550-9389
IS - 6
ER -