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Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis
Abstract
Cognitive behavioral therapy for insomnia (CBT-I) is effective for treatment of primary insomnia. There has been no synthesis of studies quantifying this effect on insomnia comorbid with medical and psychiatric disorders using rigorous selection criteria. The objective of this study was to quantify the effect of CBT-I in studies including patients with medical or psychiatric disorders. Studies were identified from 1985 through February 2014 using multiple databases and bibliography searches. Inclusion was limited to randomized controlled trials of CBT-I in adult patients with insomnia diagnosed using standardized criteria, who additionally had a comorbid medical or psychiatric condition. Twenty-three studies including 1379 patients met inclusion criteria. Based on weighted mean differences, CBT-I improved subjective sleep quality post-treatment, with large treatment effects for the insomnia severity index and Pittsburgh sleep quality index. Sleep diaries showed a 20 min reduction in sleep onset latency and wake after sleep onset, 17 min improvement in total sleep time, and 9% improvement in sleep efficiency post-treatment, similar to findings of meta-analyses of CBT-I in older adults. Treatment effects were durable up to 18 mo. Results of actigraphy were similar to but of smaller magnitude than subjective measures. CBT-I is an effective, durable treatment for comorbid insomnia.
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“The improvements in ISI insomnia symptoms are consistent with those reported in a metaanalysis of CBT-I in non-autistic populations (Geiger-Brown et al ., 2015).”
From ACT-i, an insomnia intervention for autistic adults: A pilot study (2023) · cites this paper as Geiger-Brown et al., 2015
In the citing paper
“CBT-I is recognised as being the treatment of choice for insomnia [93], both in isolated form or as a comorbidity [94], in psychiatric populations [95], among the elderly [96,97], and delivered remotely [98].”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [94]
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Metadata
- Authors
- Geiger-Brown, J. M., Rogers, V. E., Liu, W., Ludeman, E. M., Downton, K. D., & Diaz-Abad, M.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Geiger-Brown, Jeanne M.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 23
- Pages
- 54-67
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W1993723067
- Cited by
- 331
- References
- 96
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 30 · 2023: 28 · 2022: 35 · 2021: 44 · 2020: 46 · 2019: 30 · 2018: 25 · 2017: 31 · 2016: 21 · 2015: 10
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (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, comorbid insomnia, sleep quality, sleep latency, wake after sleep onset, total sleep time, sleep efficiency, actigraphy, treatment durability, Insomnia Severity Index, Pittsburgh Sleep Quality Index
- MeSH terms
- Adult, Mental Disorders, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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