Cited by 528Sleep and related disordersObstructive Sleep Apnea ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis

Wu, Jade Q., Appleman, Erica R., Salazar, Robert D., Ong, Jason C.·2015·JAMA Internal Medicine

DOI 10.1001/jamainternmed.2015.3006

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Abstract

IMPORTANCE: Cognitive behavioral therapy for insomnia (CBT-I) is the most prominent nonpharmacologic treatment for insomnia disorders. Although meta-analyses have examined primary insomnia, less is known about the comparative efficacy of CBT-I on comorbid insomnia. OBJECTIVE: To examine the efficacy of CBT-I for insomnia comorbid with psychiatric and/or medical conditions for (1) remission from insomnia; (2) self-reported sleep efficiency, sleep onset latency, wake after sleep onset, total sleep time, and subjective sleep quality; and (3) comorbid symptoms. DATA SOURCES: A systematic search was conducted on June 2, 2014, through PubMed, PsycINFO, the Cochrane Library, and manual searches. Search terms included (1) CBT-I or CBT or cognitive behavioral [and its variations] or behavioral therapy [and its variations] or behavioral sleep medicine or stimulus control or sleep restriction or relaxation therapy or relaxation training or progressive muscle relaxation or paradoxical intention; and (2) insomnia or sleep disturbance. STUDY SELECTION: Studies were included if they were randomized clinical trials with at least one CBT-I arm and had an adult population meeting diagnostic criteria for insomnia as well as a concomitant condition. Inclusion in final analyses (37 studies) was based on consensus between 3 authors' independent screenings. DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by 2 authors and pooled using a random-effects model. Study quality was independently evaluated by 2 authors using the Cochrane risk of bias assessment tool. MAIN OUTCOMES AND MEASURES: A priori main outcomes (ie, clinical sleep and comorbid outcomes) were derived from sleep diary and other self-report measures. RESULTS: At posttreatment evaluation, 36.0% of patients who received CBT-I were in remission from insomnia compared with 16.9% of those in control or comparison conditions (pooled odds ratio, 3.28; 95% CI, 2.30-4.68; P < .001). Pretreatment and posttreatment controlled effect sizes were medium to large for most sleep parameters (sleep efficiency: Hedges g = 0.91 [95% CI, 0.74 to 1.08]; sleep onset latency: Hedges g = 0.80 [95% CI, 0.60 to 1.00]; wake after sleep onset: Hedges g = 0.68; sleep quality: Hedges g = 0.84; all P < .001), except total sleep time. Comorbid outcomes yielded a small effect size (Hedges g = 0.39 [95% CI, 0.60-0.98]; P < .001); improvements were greater in psychiatric than in medical populations (Hedges g = 0.20 [95% CI, 0.09-0.30]; χ2 test for interaction = 12.30; P < .001). CONCLUSIONS AND RELEVANCE: Cognitive behavioral therapy for insomnia is efficacious for improving insomnia symptoms and sleep parameters for patients with comorbid insomnia. A small to medium positive effect was found across comorbid outcomes, with larger effects on psychiatric conditions compared with medical conditions. Large-scale studies with more rigorous designs to reduce detection and performance bias are needed to improve the quality of the evidence.

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Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,415
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099
The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response
Morin, C. M., Belleville, G., Bélanger, L., & Ivers, H. (2011) · Sleep · doi:10.1093/sleep/34.5.601 · Cited by 4,620
Meta-Analytic Procedures for Social Research.
Metcalfe, A., & Rosenthal, R. (1994) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348600 · Cited by 4,249
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215
The consensus sleep diary: standardizing prospective sleep self-monitoring
Carney, C. E., Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Krystal, A. D., Lichstein, K. L., & Morin, C. M. (2012) · Sleep · doi:10.5665/sleep.1642 · Cited by 2,172
Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27286 · Cited by 1,943
Cognitive-Behavioral Therapy for Adult Anxiety Disorders: A Meta-Analysis of Randomized Placebo-Controlled Trials
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420

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“Improvements in psychiatric outcomes such as depression have also been observed post–CBT-I treatment (Wu, Appleman, Salazar, & Ong, 2015).”
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“52 For instance, one meta-analysis of CBT-I for insomnia in individuals with physical and mental disorders reported small- to-moderate ES on comorbid symptoms with larger effects for psychiatric symptoms, 19 while”
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Background
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Background
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BackgroundInfluential
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Background
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“…timed wake therapy, light exposure) across developmental stages to identify individualized therapeutic windows, consistent with emerging evidence on sleep – inflammation mechanisms and chronotherapy (Depner et al., 2014; Irwin, 2019; Singh et al., 2021; Verkhratsky et al., 2021; Wu et al., 2015).”
Cognitive behavioral therapy for insomnia for individuals with multiple sclerosis (CALM): A randomized control trial protocol
Siengsukon, C. F., Robichaud, J., Nelson, E., Glaser, A., Baber, G., Gratton, M., Zanotto, A., Phadnis, M. A., & LYNCH, S. G. (2026) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2026.101595 · Cited by 2
“CBT-I has been shown to be highly effective in addressing sleep disturbances in people with primary insomnia [19,20], as well as in populations of people with insomnia comorbid with a variety of chronic conditions [18].”
Influential
Unstable sleep and rest-activity rhythms in adolescents at-risk for bipolar disorder: Links to mood symptoms and the effect of sleep stabilization
Santos, J. P. L., Keller, L., Hartman, A. G., Chan, S., Phillips, M. L., & Soehner, A. M. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121558 · Cited by 2
“Both packages draw from evidence-based therapies that target variable sleep patterns in psychiatric samples, including CBT for insomnia and social rhythm therapy (e.g.,(Goldstein et al., 2014a; Wu et al., 2015)).”
Acceptance and commitment therapy for insomnia: an updated meta-analysis of randomized controlled trials
Barroso, D. C., Portilho, N. D. P., Garbacka, A., Godoi, D. C., Ellwanger, M. P., Mendes, T. P., Ribeiro, V. E. A., Soares, V. G., Hespanhol, L. C., Barros, M. L. S., et al. (2026) · Journal of Clinical Sleep Medicine · doi:10.1007/s44470-026-00125-4 · Cited by 3
Insomnia in Patients with Comorbid Medical Problems
Paul, R., & Anafi, R. C. (2016) · Springer eBooks · doi:10.1007/978-3-319-41400-3_11 · Cited by 3
Recruiting “clean” chronic insomnia participants: the unicorn of sleep research
Medalie, L., Bigalke, J. A., Tikkanen, A. L., Mokhlesi, B., & Carter, J. R. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10088 · Cited by 2
Factors influencing the effectiveness of digital cognitive behavioural therapy for chronic insomnia in clinical practice
Shi, Y., Ren, R., Zhang, Y., Vitiello, M. V., & Tang, X. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14077 · Cited by 2
“…for face-to-face CBT-I; (van Ballegooijen et al., 2014) efficacy is comparable to reported remission rates of 32% – 58% for CBT-I (He et al., 2023; Wu et al., 2015) and 26% – 40% for D-CBT-I (Blom et al., 2015; Forma et al., 2022; Ritterband et al., 2022; Scott et al., 2022; Shaffer et al., 2020;…”
Sleep-specific outcomes attributable to digitally delivered cognitive behavioral therapy for insomnia in adults with insomnia and depressive symptoms
Batterham, P. J., Thorndike, F. P., Gerwien, R. W., Botbyl, J. D., Ritterband, L. M., Maricich, Y. A., & Christensen, H. M. (2023) · Behavioral Sleep Medicine · doi:10.1080/15402002.2023.2285799 · Cited by 3
“The findings are consistent with a growing body of literature that suggests face-to-face CBT-I is effective regardless of co-occurring mental health symptoms (Okajima et al., 2011; Trauer et al., 2015, Geiger-Brown et al., 2015, Wu et al., 2015).”
Result
Failure to reduce benzodiazepine prescriptions through the implementation of a psychological intervention for insomnia in an Italian mental health service
D’Avanzo, B., Parabiaghi, A., Galbussera, A. A., Tettamanti, M., Monti, I., Gregorio, L. D., Zambello, F., Goglio, M. M., Recla, E., Napoli, W. A. R. D., et al. (2024) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-024-03677-7 · Cited by 2
Sleep Deficiency, Sleep Apnea, and Chronic Lung Disease
Sunwoo, B. Y., & Owens, R. L. (2024) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2024.07.012 · Cited by 2
A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review
Khazaie, H., Sharafkhaneh, A., Zakiei, A., & Crew, E. C. (2024) · CNS Spectrums · doi:10.1017/s1092852924000385 · Cited by 2
“88 This treatment can also be done electronically and has effective outcomes for patients.”
CBTI web implementation outcomes: one-year follow up
Wardle‐Pinkston, S., Taylor, D. J., Lin, T., Dietch, J. R., Pruiksma, K. E., & Wilkerson, A. K. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2442371 · Cited by 3
“CBTI has been thoroughly established as an effective treatment through meta-analyses of randomized controlled trials in adults with chronic insomnia (Trauer et al., 2015) and adults with comorbid medical and psychiatric conditions (Wu et al., 2015).”
The applicability and effectiveness of the cognitive behavioral therapy for insomnia (Smart CBT-I plus) online program in patients with insomnia disorder combined with anxiety and depression: a randomized controlled trial protocol
Zhao, Y., Ge, F., Luo, X. R., Li, J., Zhang, J., Ju, Y., Zhang, J., Wang, Y., Lyu, D., Qiu, Y., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1450275 · Cited by 2
Update on Obstructive Sleep Apnea: Implications for Neuropsychiatry
Baker, C. A., Hurley, R. A., & Taber, K. H. (2016) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.16060115 · Cited by 2
Integration of cognitive behavioral therapy for insomnia.
Taylor, D. J., & Dietch, J. R. (2018) · Journal of Psychotherapy Integration · doi:10.1037/int0000133 · Cited by 2
Patience required: increasing sleep duration in the months to years following CBT-ICommentary on Scott H, Cheung JMY, Muench A, et al. Does total sleep time substantially increase after cognitive behavioral therapy for insomnia? J Clin Sleep Med . 2022;18(7):1823–1829. doi: 10.5664/jcsm.10004
Bramoweth, A. D. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10044 · Cited by 2
Digital Therapies for Insomnia
Jackson, M. L., Meaklim, H., & Mason, E. C. (2023) · Springer eBooks · doi:10.1007/978-3-031-10698-9_6 · Cited by 2
Sleep and Sleep–Wake Disorders
Abbott, S. M., Fiala, J. A., Mundt, J. M., Murray, J. M., & Standlee, J. (2024) · Springer eBooks · doi:10.1007/978-3-030-51366-5_62 · Cited by 2
Assessment and Treatment of Pediatric Sleep Problems: Knowledge, Skills, Attitudes and Practices in a Group of Community Child Psychiatrists
Ali, A., Yingling, M. D., Zhang, A., Ramtekkar, U. P., & Nicol, G. E. (2018) · Medical Sciences · doi:10.3390/medsci6010018 · Cited by 3
“Cognitive behavioral therapy for insomnia (CBT-I) is a structured behavioral intervention that has been shown to be effective and have fewer risks than medication [23], but was not listed by any respondents as a primary treatment strategy.”
Background
Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review protocol
Natsky, A. N., Vakulin, A., Chai‐Coetzer, C. L., Lack, L. C., McEvoy, R. D., & Kaambwa, B. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032176 · Cited by 2
Disorders of Sleep in Women: Insomnia
Khan, S. S., & Khawaja, I. S. (2019) · Psychiatric Annals · doi:10.3928/00485713-20191106-04 · Cited by 2
Comparison of the effects of cognitive-behavioral therapy for insomnia between patients with primary insomnia and comorbid insomnia
Iwashita, M., Yamadera, W., Hotchi, A., Utsumi, T., Amagai, M., Ishii, J., Suzuki, T., Itoh, H., & Shigeta, M. (2022) · Sleep and Biological Rhythms · doi:10.1007/s41105-022-00395-4 · Cited by 2
Using Insomnia as a Model for Optimizing Internet-Delivered Psychotherapy
Rumble, M. E., & Plante, D. T. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2019.19020128 · Cited by 2
Additional Approaches to Treatment of Depression
Carney, R. M. (2019) · JAMA · doi:10.1001/jama.2019.2052 · Cited by 2
Sex and gender differences
Mundt, J. M., & Dietch, J. R. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00019-0 · Cited by 2
Process evaluation protocol for the SLEEP study: a hybrid digital CBT-I intervention for working people with insomniaPreprint
Hurley-Wallace, A. L., Moukhtarian, T. R., Patel, K., Toro, C. T., Russel, S., Daley, G. Q., Walasek, L., Tang, N. K. Y., & Meyer, C. (2022) · medRxiv · doi:10.1101/2022.03.03.22271613 · Cited by 2
“[13, 14] Meta-analyses have estimated a moderate to large positive effect of CBT-I on sleep efficiency and quality in individuals with insomnia.[15] A 2020 systematic review also identified two studies that have evaluated the effectiveness of CBT-I for employees,[16-18] where one study found improvements in work produ…”
Insomnia and Sleep Disorders in Older Women
Desai, K. M., Paladine, H. L., & Pilipenko, N. (2021) · Springer eBooks · doi:10.1007/978-3-030-59058-1_8 · Cited by 1
Optimizing Behavior Strategies for Sleep
de Carvalho, L. B. C. (2021) · Springer eBooks · doi:10.1007/978-3-030-85074-6_31 · Cited by 1
Non-Pharmacological Management of Insomnia Through Electrical Vestibular Stimulation (VeNS)
Ratajczak, W., Watson, S., McKeown, J., Goothy, S. S. K., & Mohanty, K. (2024) · Current Sleep Medicine Reports · doi:10.1007/s40675-024-00296-7 · Cited by 1
“As such, a meta-analysis study demonstrated that insomnia progression often has an individual and autonomous trajectory from the comorbid disorders [7].”
Insomnia: An Update on Epidemiology, Diagnosis and Non-pharmacological Management
Francis, A. (2024) · Indian Journal of Sleep Medicine · doi:10.5005/jp-journals-10069-0131 · Cited by 1
“62,15,16 In all the above studies CBT was delivered through face-to-face sessions and also through virtual sessions.”
Applicability of a digital health application for cancer patients: a qualitative non-participation analysis
Pfeifer, K., Tewes, M., Kasper, S., Hense, J., Franco, J., Schüler, M., Schöbel, C., & Ateş, G. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11654-0 · Cited by 1
Treatment Preferences in Patients With Insomnia and Medical Comorbidity: Associated Factors and Impact on Treatment‐Outcome
Rauwerda, N. L., Pot, I., Braamse, A. M. J., van Straten, A., Nieuwkerk, P. T., Boss, M., Rikkert, M., & Knoop, H. (2025) · Journal of Sleep Research · doi:10.1111/jsr.70115 · Cited by 2
“CBT-I has been proven effective in reducing insomnia, even in patients with medical comorbidities (Okajima and Inoue 2018; Smith et al. 2005; Wu et al. 2015).”
Boosting access to evidence-based insomnia care: our experience with a stepped care approach in Canada
Davidson, J. R., Gardner, D. M., Fretz, K. M., Lynch, S., Watson, S., Desmarais, E., Sloan, E. P., & Leung, C. (2025) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaf032 · Cited by 1
Causal association between insomnia and diabetic nephropathy independent of diabetes: Evidence from 2-sample Mendelian randomization analysis
Zhang, J. B., Liu, B., Han, J., & Gu, X. (2025) · Medicine · doi:10.1097/md.0000000000045368 · Cited by 1
“[28] Several MR studies have investigated the causal relationships between insomnia and various health outcomes and between potential risk factors and diabetic nephropathy.”
Behavioral interventions as treatment for insomnia – A scoping review of randomized controlled trials
Hodge, B., Richert, E., Schmitz, L., Íslind, A. S., Leppänen, T., McNicholas, W. T., Arnardóttir, E. S., & Pires, G. N. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108676 · Cited by 1
Best-Practice Mental Health Interventions Following Acute Cardiovascular Events
Abreu, M. N., Albuquerque, R. P., & Fonseca, A. (2026) · Cardiology Clinics · doi:10.1016/j.ccl.2025.12.005 · Cited by 1
Associations between Sleep Problems, Psychotic Experiences and Mental Disorders in Children at Familial High Risk of Schizophrenia or Bipolar Disorder and Population-based controls - The Danish High Risk and Resilience Study
Søndergaard, A., Hemager, N., Wilms, M., Rohd, S. B., Krantz, M. F., Greve, A. N., Veddum, L., Thorup, A. A. E., Nordentoft, M., & Gregersen, M. (2026) · Schizophrenia Research · doi:10.1016/j.schres.2026.02.020 · Cited by 1
Predictors and moderators of treatment outcomes from cognitive behavioural interventions for insomnia in adults: A systematic review
Smith, M. L., Oldenhof, E., Byrne, J. E. M., McNeill, I. M., Sweetman, A., & Staiger, P. K. (2026) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2026.102269 · Cited by 1
The impact of cognitive behavioral therapy for insomnia on cognitive performance and amyloid beta in older adults: A randomized controlled trial
Siengsukon, C. F., Hand, L. K., Nelson, E., Glaser, A., Ludwig, R. L., Russell, J. A., Phadnis, M. A., Dai, J., Bruce, J. M., Vidoni, E. D., et al. (2026) · Alzheimer s & Dementia · doi:10.1002/alz.71591 · Cited by 1

Authors: Wu, J. Q., Appleman, E. R., Salazar, R. D., & Ong, J. C.
Affiliations: Boston University (US)
Rush University Medical Center (US)
ORCID: Wu, Jade Q.
Appleman, Erica R.
Ong, Jason C.
Venue: JAMA Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2015-09-01
Volume: 175
Issue: 9
Pages: 1461
ISSN: 2168-6106 (ISSN-L)
DOI: 10.1001/jamainternmed.2015.3006
OpenAlex: W1574691271
Cited by: 527
References: 65
Citations by year: 2026: 34 · 2025: 45 · 2024: 38 · 2023: 55 · 2022: 65 · 2021: 60 · 2020: 51 · 2019: 48 · 2018: 44 · 2017: 46 · 2016: 32 · 2015: 7
FWCI: 64.76
Type: journal article
Language: en
Open access: closed
Locations: JAMA Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: cognitive behavioral therapy for insomnia, insomnia comorbidity, psychiatric comorbidity, comorbidities, insomnia remission, sleep efficiency, sleep latency, wake after sleep onset, subjective sleep quality, sleep restriction, stimulus control, relaxation training, paradoxical intention, risk of bias
MeSH terms: Mental Disorders, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Cognitive Behavioral Therapy, Treatment Outcome

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Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis

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