Acceptance and Commitment Therapy as an Adjunct or Alternative Treatment to Cognitive Behavioral Therapy for Insomnia
Open accessAbstract
Although cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment of insomnia, difficulties exist with adherence to recommendations and premature discontinuation of treatment does occur. The current article aims to review existing research on acceptance and commitment therapy (ACT)-based interventions, demonstrate differences and similarities between ACT for insomnia and CBT-I, and describe treatment components and mechanisms of ACT that can be used to treat insomnia disorder.
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ACT processes of mindfulness, acceptance and defusion can be used to reduce cognitive arousals and counterproductive sleep efforts.
“the ACT process of mindfulness, acceptance and defusion can indeed be used to reduce cognitive arousals and counterproductive sleep efforts.14”
From SoundMind Trial: a study protocol for a randomised controlled trial for online acceptance and commitment therapy and sound therapy for tinnitus (2024) · cites this paper as [14]
Individual sensitivity to sound varies considerably: some individuals are highly sensitive to even minor sounds, others benefit from gentle background noise that masks disturbances.
“Individual sensitivity to sound varies considerably: while some individuals are highly sensitive to even minor sounds, others benefit from gentle background noise that masks disturbances [54,55].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [54]
The Introduction’s CBT-I section says sleep hygiene addresses environmental conditions, but does not discuss sensitivity to sound or the use of background noise to mask disturbances. Searches for sound sensitivity, masking, and white noise found no passage addressing those points. (LLM, conf=0.74)
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- Authors
- Saldaña, K. S., McGowan, S. K., & Martin, J. L.
- Affiliations
- VA Greater Los Angeles Healthcare System (US)
- University of California, Los Angeles (US)
- Corresponding author
- Martin, Jennifer L.
- Venue
- Sleep Medicine Clinics
- Publisher
- Elsevier BV
- Published
- 2023-03
- Volume
- 18
- Issue
- 1
- Pages
- 73-83
- ISSN
- 1556-407X (ISSN-L)
- PMC
- PMC10182873
- OpenAlex
- W4319781780
- Cited by
- 20
- References
- 37
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7 · 2023: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Sleep Medicine Clinics (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- VA Greater Los Angeles Healthcare System
- National Institutes of Health
- VA Health Services Research and Development Service (IIR 16-244, RCS 20-191)
- Office of Academic Affiliations, Department of Veterans Affairs
- Geriatric Research Education and Clinical Center
- National Heart, Lung, and Blood Institute (/ NHLBI K24 HL143055)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acceptance and commitment therapy, cognitive behavioral therapy for insomnia, insomnia, adjunctive therapy, alternative treatment, medication adherence, premature treatment discontinuation, therapeutic mechanisms
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy, Treatment Outcome, Acceptance and Commitment Therapy
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