Residual sleep beliefs and sleep disturbance following cognitive behavioral therapy for major depression
Open accessAbstract
BACKGROUND: Sleep disturbance is a commonly reported residual symptom after effective depression treatment. This residual sleep impairment, as well as the presence of problem levels of certain sleep beliefs, may be important for depressive relapse prevention, and as such should be addressed in treatment. The following study examined residual sleep disturbance and residual maladaptive sleep beliefs in those treated with Cognitive Behavior Therapy for depression. METHODS: Participants (N = 24) were clinic patients seeking treatment for depression at a community clinic. Repeated measures analyses of variance tested pre- to posttreatment change on depression symptoms, general negative beliefs, sleep quality, and maladaptive sleep beliefs. RESULTS: As expected, significant time effects were found for depressive symptoms and general negative beliefs. Sleep quality scores also decreased significantly at posttreatment; however, 92% of those no longer meeting depressive criteria continued to endorse residual sleep disturbance, according to an established clinical cutoff score of > 5 on a validated measure of sleep quality (the Pittsburgh Sleep Quality Index). There were no significant pre- to posttreatment changes for maladaptive sleep beliefs. CONCLUSIONS: The results indicate that sleep disturbance and maladaptive sleep-related beliefs remain a problematic residual symptom of remitted depression. These findings are discussed with reference to improving cognitive behavioral treatments for depression in order to help reduce rates of residual sleep problems.
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Insomnia often persists despite successful antidepressant treatment and increases the risk of relapse into depression.
“Research, however, has demonstrated that on the contrary, insomnia often persists despite successful antidepressant treatment and increases the risk of a relapse into depression [6].”
From Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis (2022) · cites this paper as [6]
Absence of insomnia after successful antidepressant treatment is a predictor for restoration of a normal level of functioning.
“Absence of insomnia after successful antidepressant treatment is a predictor for the restoration of a normal level of functioning [6].”
From Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis (2022) · cites this paper as [6]
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Manber, R., Dietch, J. R., Gumport, N. B., & Simpson, N. S. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.28
The relation between sleep and affect in youth during remission from anxiety and depression
Kooiman, B., Vuuregge, A. H., Robberegt, S. J., Wilts, N., Stikkelbroek, Y. A. J., Bockting, C., Schrantee, A., Mul, J. D., Lucassen, P. J., Albers, C. J., et al. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121878
Insomnia beyond emotion regulation in adolescent anxiety and depression: A severity-based analysis
Sánchez-Moreno, V., Cavas, M., & Rey, L. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.07.019
Hamilton, J. M., Pain, É., Riise, J., & Zhang, Z. (2026) · Interactive Journal of Medical Research · doi:10.2196/93231
- Authors
- Carney, C. E., Harris, A. L., Friedman, J., & Segal, Z. V.
- Affiliations
- University of Toronto (CA)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Carney, Colleen E.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2011-03-11
- Volume
- 28
- Issue
- 6
- Pages
- 464-470
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W2101207278
- Cited by
- 50
- References
- 49
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 1 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 5 · 2012: 2
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- 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
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- major depressive disorder, sleep quality, Pittsburgh Sleep Quality Index, remitted depression, depressive relapse prevention, negative beliefs
- MeSH terms
- Adult, Aged, Antidepressive Agents, Combined Modality Therapy, Culture, Major Depressive Disorder, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Personality Inventory, Psychometrics, Quality of Life, Comorbidity, Cognitive Behavioral Therapy, Young Adult
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