Group CBT for Insomnia: A Meta-Analysis

Insomnia is the most common sleep disorder among the general population. Although cognitive behavioral therapy for insomnia (CBT-I) is the psychological treatment of choice, the availability of individual therapy is often not sufficient to meet the demand for treatment. Group treatment can increase the efficiency of delivery, but its efficacy has not been well-established. Randomized controlled trials (RCTs) comparing group CBT-I to a control group in patients with insomnia were identified. A review of 670 unique citations resulted in eight studies that met criteria for analysis. Outcome variables included both qualitative (e.g., sleep quality) and quantitative (e.g., sleep diary) outcomes, as well as depression and pain severity, at both pre- to post-treatment and follow-up (3-12 mo post-treatment). Overall, we found medium to large effect sizes for sleep onset latency, sleep efficiency, and wake after sleep onset and small effect sizes for pain outcomes. Effect sizes remained significant at follow-up, suggesting that treatment gains persist over time. Other variables, including total sleep time, sleep quality, and depression, showed significant improvements, but these findings were limited to the within treatment group analyses. It is clear that group CBT-I is an efficacious treatment. Implications for stepped care models for insomnia are discussed.

Koffel, E., Koffel, J., & Gehrman, P. (May 01, 2014). A Meta-analysis of Group Cognitive Behavioral Therapy for Insomnia. Sleep Medicine Reviews.

Individual versus Group Cognitive Behavior Therapy for Insomnia

Cognitive behavior therapy for insomnia (CBT-I) has been identified as an effective treatment for primary insomnia, and according to a recent study published in Sleep and Biological Rhythms, individual CBT-I may be a superior treatment approach to group CBT-I.

In the current study, researchers compared the short-term effectiveness of both individual and group CBT-I, in individuals who met DSM-IV-TR criteria for primary insomnia (i.e., a fear of insomnia, increased somatic tension, and mental arousal in bed).  In addition to primary diagnoses of insomnia, all participants in the study also reported chronic use of hypnotics and engaged in either individual CBT-I (n=20) or group CBT-I (n=25).  Both groups were exposed to the same major treatment components, including education concerning sleep hygiene, as well as stimulus control, sleep restriction, and cognitive therapies.  Pre and post-treatment evaluations utilized sleep logs, the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), the Pittsburgh Sleep Quality Index (PSQI) and actigraphy (a non-invasive method of monitoring human rest/activity cycles) to assess sleep outcomes between participant groups.

Findings revealed that overall, both individual and group CBT-I produced positive sleep outcomes.  However, across multiple objective and subjective sleep measurements, individual CBT-I resulted in significantly greater participant gains over group CBT-I.  These results support the use of individual CBT-I above group CBT-I when treating primary insomnia.

Yamadera, W., Sato, M., Harada, D., Iwashita, M., Aoki, R., Obuchi, K., Ozone, M., … Nakayama, K. (July 07, 2013). Comparisons of short-term efficacy between individual and group cognitive behavioral therapy for primary insomnia. Sleep and Biological Rhythms, 11, 3, 176-184.

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Cognitive-Behavioral Therapy is Effective for Insomnia

newstudy-graphic-66x60.jpgData continues to emerge about the public health and economic burden of insomnia. This data comes from increased health risks including increased utilization of health care and work domain deficits such as absenteeism and reduced productivity. The National Institutes of Health Consensus and the American Academy of Sleep Medicine Practice Parameters have made the recommendation that cognitive-behavioral therapy (CBT) be the standard treatment for insomnia. CBT for insomnia is a brief, non-pharmacologic approach that is based on the science of sleep medicine, behavior change, and psychosocial theory. Further, in randomized controlled trials in which CBT is compared to medication, CBT has proven to be comparably effective, with more durable long-term maintenance of gains after treatment is discontinued. To read the entire article, click here:

Research Results: Having Trouble Sleeping? Experts Recommend CBT for Insomnia

The American Academy of Sleep Medicine recently published updated guidelines for treating Insomnia and recommended Cognitive Behavior Therapy (CBT) as an effective, evidence-based treatment. The Academy’s new guidelines are based on a large review of 37 sleep studies that examined the effectiveness of various treatments for 2,246 insomnia patients. This review showed that Cognitive Behavioral Therapy (CBT), among other behavioral/psychological interventions, is an effective treatment for insomnia, and that sleep improvements last over time.