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Adherence to cognitive behavioral therapy for insomnia: A systematic review
Open accessAbstract
Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive behavioral therapy for insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to 1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, 2) discuss measurement issues, and 3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts.
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Cited by
Sorted by citations
Johnson, J. A., Rash, J. A., Campbell, T. S., Savard, J., Gehrman, P. R., Perlis, M., Carlson, L. E., & Garland, S. N. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.07.001 · Cited by 371
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“Clear evidence supports the benefits of cognitive behavior therapy (CBT-I) for the management of chronic insomnia regardless of comorbidities (114).”
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Systematic Review and Meta-analysis of Adolescent Cognitive–Behavioral Sleep Interventions
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“…predictors of treatment adherence (e.g., baseline symptoms (short sleep duration, anxiety, depression), self-efficacy, and attitude to treatment; Matthews et al. 2013), dose–response relationships (i.e., highvs. low-intensity treatments), and temporal relations between variables (Morin et al.…”
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Metadata
- Authors
- Matthews, E. E., Arnedt, J. T., McCarthy, M. S., Cuddihy, L. J., & Aloia, M. S.
- Affiliations
- University of Colorado Denver (US)
- University of Michigan (US)
- Pine Rest Christian Mental Health Services (US)
- National Jewish Health (US)
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 17
- Issue
- 6
- Pages
- 453-464
- ISSN
- 1087-0792 (ISSN-L)
- PMC
- PMC3720832
- OpenAlex
- W2018449766
- Cited by
- 199
- References
- 76
- Citations by year
- 2026: 17 · 2025: 11 · 2024: 27 · 2023: 26 · 2022: 22 · 2021: 15 · 2020: 15 · 2019: 13 · 2018: 8 · 2017: 19 · 2016: 4 · 2015: 13 · 2014: 9
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Health
- National Institute of Nursing Research (1K23NR010587, #2010-049)
- American Nurses Foundation
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy for insomnia, medication adherence, chronic insomnia, attrition, adherence measurement, behavior change, sleep outcomes, standardized outcome measures
- MeSH terms
- Adult, Humans, Sleep Initiation and Maintenance Disorders, Patient Compliance, Cognitive Behavioral Therapy
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