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A meta-analysis of group cognitive behavioral therapy for insomnia
Open accessAbstract
Insomnia is the most common sleep disorder among the general population. Although cognitive behavioral therapy for insomnia (CBT-I) is the psychological treatment of choice, the availability of individual therapy is often not sufficient to meet the demand for treatment. Group treatment can increase the efficiency of delivery, but its efficacy has not been well-established. Randomized controlled trials (RCTs) comparing group CBT-I to a control group in patients with insomnia were identified. A review of 670 unique citations resulted in eight studies that met criteria for analysis. Outcome variables included both qualitative (e.g., sleep quality) and quantitative (e.g., sleep diary) outcomes, as well as depression and pain severity, at both pre- to post-treatment and follow-up (3-12 mo post-treatment). Overall, we found medium to large effect sizes for sleep onset latency, sleep efficiency, and wake after sleep onset and small effect sizes for pain outcomes. Effect sizes remained significant at follow-up, suggesting that treatment gains persist over time. Other variables, including total sleep time, sleep quality, and depression, showed significant improvements, but these findings were limited to the within treatment group analyses. It is clear that group CBT-I is an efficacious treatment. Implications for stepped care models for insomnia are discussed.
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“As would be expected given that most eligible trials were of CBT-I, or CBT-informed interventions for insomnia, the effect on depression symptoms we identified is comparable to the effects on depression symptoms reported in previous meta-analyses of CBT-I for insomnia [36][37][38].”
From The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials (2019) · cites this paper as [37]
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“The results of previous meta-analyses suggest that both internet-delivered [36] and group-based [37] CBT-I have small but significant effects on depression symptoms, despite these symptoms not being specifically targeted.”
From The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials (2019) · cites this paper as [37]
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Metadata
- Authors
- Koffel, E. A., Koffel, J. B., & Gehrman, P. R.
- Affiliations
- University of Minnesota (US)
- Philadelphia VA Medical Center (US)
- Corresponding author
- Koffel, Erin A.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 19
- Pages
- 6-16
- ISSN
- 1087-0792 (ISSN-L)
- PMC
- PMC4910506
- OpenAlex
- W2148760176
- Cited by
- 356
- References
- 50
- Citations by year
- 2026: 13 · 2025: 32 · 2024: 31 · 2023: 31 · 2022: 34 · 2021: 36 · 2020: 33 · 2019: 38 · 2018: 31 · 2017: 33 · 2016: 23 · 2015: 16
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Institutes of Health (VA999999)
- 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 › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy for insomnia, group therapy, insomnia, sleep latency, sleep efficiency, wake after sleep onset, total sleep time, sleep quality, pain, depression, treatment efficacy, treatment retention, stepped care
- MeSH terms
- Adult, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Outcome and Process Assessment, Health Care, Psychotherapy, Group, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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