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Jennifer L Martin, M Safwan Badr, Salam Zeineddine
Sleep disorders are common among women veterans and contribute to poor functioning and quality of life. Studies show that women veterans are particularly prone to insomnia, sleep-disordered breathing, and insufficient sleep. Standard cognitive behavioral therapy for insomnia (CBT-I) should be viewed as first-line therapy for insomnia disorder, and women veterans should be screened and treated for sleep-disordered breathing. Behavioral and lifestyle factors contributing to insufficient sleep should also be addressed...
September 2018: Sleep Medicine Clinics
Vivian W Chiu, Melissa Ree, Aleksandar Janca, Rajan Iyyalol, Milan Dragovic, Flavie Waters
This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment. Sleep profiling was conducted using latent class analysis on baseline Pittsburgh Sleep Quality Index data (N = 74 outpatients with schizophrenia who were poor sleepers, 52% male, mean age = 41.4 years). Of these, 40 took part in CBT-I treatment. Analyses revealed three sleep subtypes based on total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) parameters: Cluster 1 ('classic severe insomnia', 44...
July 24, 2018: Psychiatry Research
Joanie Mercier, Hans Ivers, Josée Savard
Study objectives: Thirty to 60% of cancer patients have insomnia symptoms, a condition which may lead to numerous negative consequences and for which an efficacious management is required. This randomized controlled trial aimed to assess the efficacy of a 6-week home-based aerobic exercise program (EX) compared to that of a 6-week self-administered cognitive-behavioral therapy for insomnia (CBT-I) to improve sleep in cancer patients. Method: Forty-one patients (78...
July 25, 2018: Sleep
Naoko Ayabe, Isa Okajima, Shun Nakajima, Yuichi Inoue, Norio Watanabe, Wataru Yamadera, Naohisa Uchimura, Hisateru Tachimori, Yuichi Kamei, Kazuo Mishima
OBJECTIVES: An insomnia characterized by nighttime symptoms and daytime impairment is common. GABA-A receptor agonist (GABAA-RA) treatment is often used, but long-term use is controversial due to the poor risk-benefit ratio resulting from drug dependence and potential cognitive impairment. This study evaluated the effectiveness of add-on cognitive behavioral therapy for insomnia (CBT-I) and GABAA-RA dose-tapering in patients with primary insomnia resistant to pharmacotherapy. METHODS: This randomized, multicenter, two-arm, parallel-group study compared CBT-I and treatment as usual (TAU) in patients with persistent primary insomnia despite GABAA-RA treatment...
June 18, 2018: Sleep Medicine
Jennifer C Kanady, Lisa S Talbot, Shira Maguen, Laura D Straus, Anne Richards, Leslie Ruoff, Thomas J Metzler, Thomas C Neylan
STUDY OBJECTIVES: Our study aims were to examine (1) the association between fear of sleep and posttraumatic stress disorder (PTSD) symptoms, (2) the association between fear of sleep and subjective and objective insomnia symptoms and disruptive behaviors during sleep, and (3) whether fear of sleep decreases following cognitive behavioral therapy for insomnia (CBT-I). METHODS: Forty-five adults with PTSD and insomnia participated in the study. Fear of sleep was assessed using the Fear of Sleep Inventory; PTSD symptoms were assessed using the Clinician Administered PTSD Scale; and sleep disturbance symptoms were assessed using the Insomnia Severity Index, polysomnography, sleep diaries, and the Pittsburgh Sleep Quality Index Addendum for PTSD...
July 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Christina Sandlund, Kimberly Kane, Mirjam Ekstedt, Jeanette Westman
BACKGROUND: The majority of patients who seek help for insomnia do so in primary health care. Nurse-led group treatment in primary care based on cognitive behavioral therapy for insomnia (CBT-I) can lead to improvements in both day- and nighttime symptoms. This study aimed to explore patients' experiences of nurse-led group treatment for insomnia in primary health care. METHODS: Seventeen patients who had participated in the group treatment program were interviewed in five focus groups...
July 9, 2018: BMC Family Practice
Barbara J Limandri
Acute and chronic insomnia are common and difficult clinical problems that contribute to and are consequences of other mental and physical health problems. It is tempting to treat insomnia with medications for rapid relief; however, these medications have significant side effects that add health burden and may cause tolerance and dependency. First-line treatment for insomnia is cognitive-behavioral therapy for insomnia (CBT-I); however, this is less frequently prescribed than benzodiazepine and non-benzodiazepine sedative hypnotic agents...
July 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
Muneto Izuhara, Hiroyuki Matsuda, Ami Saito, Maiko Hayashida, Syoko Miura, Arata Oh-Nishi, Ilhamuddin Abdul Azis, Rostia Arianna Abdullah, Keiko Tsuchie, Tomoko Araki, Arauchi Ryousuke, Misako Kanayama, Sadayuki Hashioka, Rei Wake, Tsuyoshi Miyaoka, Jun Horiguchi
The authors present the case of a 38-year-old man with schizophrenia and with severe insomnia, who attempted suicide twice during oral drug therapy with risperidone. The patient slept barely 2 or 3 h per night, and he frequently took half days off from work due to excessive daytime sleepiness. As a maladaptive behavior to insomnia, he progressively spent more time lying in bed without sleeping, and he repeatedly thought about his memories, which were reconstructed from his hallucinations. His relatives and friends frequently noticed that his memories were not correct...
2018: Frontiers in Psychiatry
Annika Norell-Clarke, Maria Tillfors, Markus Jansson-Fröjmark, Fredrik Holländare, Ingemar Engström
BACKGROUND: Recent treatment studies with cognitive behavioural therapy for insomnia (CBT-I) have demonstrated effects on both sleep problems and depression. Two previous studies have indicated that the beneficial effect from CBT-I on depression may come through improved sleep, although insomnia severity during treatment had not previously been investigated as a mediator. AIMS: Our aim was to investigate if insomnia severity during treatment mediated between CBT-I and depression severity after treatment, in a sample with co-morbid insomnia and depressive symptomology...
June 14, 2018: Behavioural and Cognitive Psychotherapy
Christina Sandlund, Jerker Hetta, Gunnar H Nilsson, Mirjam Ekstedt, Jeanette Westman
BACKGROUND: People typically seek primary health care for daytime symptoms and impairments they experience in association with their insomnia. However, few studies address the question of whether insomnia treatment can improve such symptomatology. OBJECTIVES: To investigate whether a nurse-led group treatment program, based on the techniques of cognitive behavioral therapy for insomnia (CBT-I), improved daytime symptomatology in primary care patients with insomnia...
May 24, 2018: International Journal of Nursing Studies
Paul Sadler, Suzanne McLaren, Britt Klein, Jack Harvey, Megan Jenkins
Study Objectives: To investigate whether cognitive behaviour therapy was effective for older adults with comorbid insomnia and depression in a community mental health setting, and explore whether an advanced form of cognitive behaviour therapy for insomnia produced better outcomes compared to a standard form of cognitive behaviour therapy for insomnia. Methods: An 8 week randomized controlled clinical trial was conducted within community mental health services, Victoria, Australia...
May 24, 2018: Sleep
Philip Cheng, Annemarie I Luik, Cynthia Fellman-Couture, Edward Peterson, Christine L M Joseph, Gabriel Tallent, Kieulinh Michelle Tran, Brian K Ahmedani, Timothy Roehrs, Thomas Roth, Christopher L Drake
BACKGROUND: Insomnia and depression are highly comorbid and mutually exacerbate clinical trajectories and outcomes. Cognitive behavioral therapy for insomnia (CBT-I) effectively reduces both insomnia and depression severity, and can be delivered digitally. This could substantially increase the accessibility to CBT-I, which could reduce the health disparities related to insomnia; however, the efficacy of digital CBT-I (dCBT-I) across a range of demographic groups has not yet been adequately examined...
May 24, 2018: Psychological Medicine
Zhong-Rui Ma, Li-Jun Shi, Ming-Hong Deng
Insomnia is highly prevalent in children and adolescents. However, the efficacy of cognitive behavioral therapy for insomnia (CBT-i) in children and adolescents remains controversial. Therefore, this systematic review and meta-analysis aimed to assess the efficacy of CBT-i in children and adolescents. We conducted a search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO to select primary studies evaluating CBT-i in children and adolescents that were primarily diagnosed through standardized diagnostic criteria...
2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Philip I Chow, Karen S Ingersoll, Frances P Thorndike, Holly R Lord, Linda Gonder-Frederick, Charles M Morin, Lee M Ritterband
OBJECTIVE: The aim of this study was to investigate in a randomized clinical trial the role of sleep-related cognitive variables in the long-term efficacy of an online, fully automated cognitive behavioral therapy intervention for insomnia (CBT-I) (Sleep Healthy Using the Internet [SHUTi]). METHOD: Three hundred and three participants (Mage  = 43.3 years; SD = 11.6) were randomly assigned to SHUTi or an online patient education condition and assessed at baseline, postintervention (nine weeks after baseline), and six and 12 months after the intervention period...
July 2018: Sleep Medicine
Vincenza Castronovo, Andrea Galbiati, Marco Sforza, Mattia Poletti, Laura Giarolli, Tracy Kuo, Marco Zucconi, Mauro Manconi, Michael Hensley, Charles Morin, Luigi Ferini-Strambi
OBJECTIVE: Cognitive-behavioral therapy for insomnia (CBT-I) is recognized as the first-choice intervention for insomnia. One of the best-known advantages of CBT-I in comparison with pharmacotherapy is its long-term effect. However, only few studies have assessed its benefits with follow-up periods of longer than three years. In this clinical case series study we aimed to describe the long-term effects of group CBT-I after a mean 7.8 ± 1.6 years of follow-up (range 4-10 years). METHODS: A total of 292 insomnia disorder (ID) patients were consecutively enrolled at the Sleep Disorders Center of San Raffaele Hospital, Milan; 123 patients (82 (66...
July 2018: Sleep Medicine
T van der Zweerde, A van Straten, M Effting, S D Kyle, J Lancee
BACKGROUND: Insomnia is effectively treated with online Cognitive Behavioral Therapy for Insomnia (CBT-I). Previous research has suggested the effects might not be limited to sleep and insomnia severity, but also apply to depressive symptoms. Results, however, are mixed. METHODS: In this randomized controlled trial we investigated the effects of guided online CBT-I on depression and insomnia in people suffering from symptoms of both. Participants (n = 104) with clinical insomnia and at least subclinical depression levels were randomized to (1) guided online CBT-I and sleep diary monitoring (i-Sleep) or (2) control group (sleep diary monitoring only)...
May 11, 2018: Psychological Medicine
Kyung Mee Park, Tae Ho Kim, Woo Jung Kim, Suk Kyoon An, Kee Namkoong, Eun Lee
Objective: This study determined whether cognitive behavioral therapy for insomnia (CBT-i) decreased the need for sleep medications and produced better treatment outcomes than pharmacotherapy alone. Methods: We reviewed data from patients with insomnia in the outpatient clinic of a general hospital between 2009 and 2015. We compared 41 patients who received five sessions of CBT-i with 100 age- and sex-matched patients who received pharmacotherapy only. We evaluated the change in prescription for sleep (i...
April 27, 2018: Psychiatry Investigation
Ayah Ismail, Catherine Moore, Natasha Alshishani, Khalid Yaseen, Mansour Abdullah Alshehri
[Purpose] To investigate the effectiveness of cognitive-behavioural therapy (CBT) and pain coping skills training (PCST) on pain level in adults with osteoarthritis of the knee (KOA) in comparison with usual care. [Subjects and Methods] Five databases were systematically searched for relevant randomised controlled trials (RCTs) according to the selected eligibility criteria (inception to June 7, 2016). PEDro scale was used to assess the validity of included studies. [Results] Four studies met the inclusion criteria and all studies had high methodological quality...
December 2017: Journal of Physical Therapy Science
Erin Koffel, Adam D Bramoweth, Christi S Ulmer
The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review...
June 2018: Journal of General Internal Medicine
Robert Zachariae, Ali Amidi, Malene F Damholdt, Cecilie D R Clausen, Jesper Dahlgaard, Holly Lord, Frances P Thorndike, Lee M Ritterband
Background: Insomnia is two to three times more prevalent in cancer survivors than in the general population, where it is estimated to be 10% to 20%. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, but meeting survivor needs remains a challenge. Internet-delivered CBT-I (iCBT-I) has been shown efficacious in otherwise healthy adults. We tested the efficacy of iCBT-I in breast cancer survivors with clinically significant sleep disturbance...
February 20, 2018: Journal of the National Cancer Institute
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