The DOI matches its Crossref record; 36 of the 37 references it cites were found in a registry or an index.
Cognitive Behavioral Therapy for Treatment of Chronic Primary Insomnia: A Randomized Controlled Trial
Abstract
CONTEXT: Use of nonpharmacological behavioral therapy has been suggested for treatment of chronic primary insomnia, but well-blinded, placebo-controlled trials demonstrating effective behavioral therapy for sleep-maintenance insomnia are lacking. OBJECTIVE: To test the efficacy of a hybrid cognitive behavioral therapy (CBT) compared with both a first-generation behavioral treatment and a placebo therapy for treating primary sleep-maintenance insomnia. DESIGN AND SETTING: Randomized, double-blind, placebo-controlled clinical trial conducted at a single academic medical center, with recruitment from January 1995 to July 1997. PATIENTS: Seventy-five adults (n = 35 women; mean age, 55.3 years) with chronic primary sleep-maintenance insomnia (mean duration of symptoms, 13.6 years). INTERVENTIONS: Patients were randomly assigned to receive CBT (sleep education, stimulus control, and time-in-bed restrictions; n = 25), progressive muscle relaxation training (RT; n = 25), or a quasi-desensitization (placebo) treatment (n = 25). Outpatient treatment lasted 6 weeks, with follow-up conducted at 6 months. MAIN OUTCOME MEASURES: Objective (polysomnography) and subjective (sleep log) measures of total sleep time, middle and terminal wake time after sleep onset (WASO), and sleep efficiency; questionnaire measures of global insomnia symptoms, sleep-related self-efficacy, and mood. RESULTS: Cognitive behavioral therapy produced larger improvements across the majority of outcome measures than did RT or placebo treatment. For example, sleep logs showed that CBT-treated patients achieved an average 54% reduction in their WASO whereas RT-treated and placebo-treated patients, respectively, achieved only 16% and 12% reductions in this measure. Recipients of CBT also showed a greater normalization of sleep and subjective symptoms than did the other groups with an average sleep time of more than 6 hours, middle WASO of 26.6 minutes, and sleep efficiency of 85.1%. In contrast, RT-treated patients continued to report a middle WASO of 43.3 minutes and sleep efficiency of 78.8%. CONCLUSIONS: Our results suggest that CBT represents a viable intervention for primary sleep-maintenance insomnia. This treatment leads to clinically significant sleep improvements within 6 weeks and these improvements appear to endure through 6 months of follow-up.
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“Furthermore, previous studies have found that CBT-i results in significantly greater insomnia improvements than a placebo control group [30].”
In the citing paper
“CBT is the standard of care for many psychiatric disorders including depression, anxiety disorders, eating disorders, addiction, chronic pain and sleeping disturbance (insomnia) across the spectrum of acuity.16–20”
In the citing paper
“The low levels of baseline SWS seen in our older participants—similar to other populations of older adults (28)—may have mitigated the detection of increases in those sleep stages.”
From Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints (2008) · cites this paper as [28]
Citations
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“Firstgeneration behavioral therapies, designed to correct sleep-disruptive habits (eg, stimulus control) or reduce bedtime arousal (eg, relaxation training [RT]), have proven very effective for treating sleep onset problems, but their results among the larger PPI subgroup reporting sleep maintenance complaints have be…”
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Social media and suicidal behaviors: interpersonal causes, media effects, and ethical implications
Michaels, T., & Corr, M. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-90237-3.00009-6 · Cited by 1
Yanjana, Chandrakar, A., Shrivastava, P., Sahu, M. K., Antony Wilson, M. J., Thomas, S., & Kumar, M. (2024) · International Research Journal of Multidisciplinary Scope · doi:10.47857/irjms.2024.v05i02.0295
“Numerous research works have reported a noteworthy impact of relaxation on autonomic activity in relation to GSR, EMG, and RR (17 – 21, 24 ).”
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Chapter 58. Treatment of Insomnia
Krystal, A. D. (2024) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375523.as58
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“…several studies have shown that CBTi is as effective as medication in the short-term (Health June 13 – 15, 2005; Wilt et al ., 2016), with considerably better long-term outcomes (Edinger and Sampson, 2003; Edinger et al ., 2001; Jacobs et al ., 2004; Morin et al ., 1999; Sivertsen et al ., 2006).”
CBT-I for Insomnia During the Perinatal Period
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Addressing Depression and Insomnia in Cognitive Behavioral Therapy
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SLEEP AND MENTAL HEALTH: THE RELATIONSHIP BETWEEN SLEEP DISORDERS AND DEPRESSION
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“Research has demonstrated the effectiveness of CBT-I in improving insomnia symptoms, sleep efficiency, and overall sleep quality across diverse populations (Koffel et al., 2015; Wu et al., 2015; Smith et al., 2002; Edinger et al., 2001).”
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A Generative Multi-agent Framework for Modeling Depressive Language Entrainment
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Treating Insomnia in General Practice
Camilleri, M. A. (2007) · OAR@UM (University of Malta)
Metadata
- Authors
- Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E.
- Affiliations
- Durham VA Medical Center (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2001-04-11
- Volume
- 285
- Issue
- 14
- Pages
- 1856
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2090423345
- Cited by
- 625
- References
- 37
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 21 · 2023: 19 · 2022: 16 · 2021: 29 · 2020: 25 · 2019: 29 · 2018: 22 · 2017: 29 · 2016: 37 · 2015: 38 · 2014: 40 · 2013: 43 · 2012: 20
- FWCI
- 28.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH48187, R01MH048187)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- cognitive behavioral therapy, chronic primary insomnia, sleep maintenance insomnia, progressive muscle relaxation, stimulus control, sleep education, wake after sleep onset, sleep efficiency, non-pharmacological treatment
- MeSH terms
- Adult, Aged, Double-Blind Method, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Surveys and Questionnaires, Relaxation Therapy, Cognitive Behavioral Therapy, Polysomnography
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