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Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis

Geiger-Brown, Jeanne M., Rogers, Valerie E., Liu, Wen, Ludeman, Emilie M., Downton, Katherine D., Diaz-Abad, Montserrat·2015·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2014.11.007

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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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European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049
Sleep, insomnia, and depression
Riemann, D. W., Krone, L. B., Wulff, K., & Nissen, C. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0411-y · Cited by 901
The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023
Riemann, D., Espie, C. A., Altena, E., Arnardottir, E. S., Baglioni, C., Bassetti, C. L. A., Bastien, C., Berzina, N., Bjorvatn, B., Dikeos, D., et al. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14035 · Cited by 834
Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis
van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.02.001 · Cited by 676
A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors
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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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.
ORCID: Geiger-Brown, Jeanne M.
Rogers, Valerie E.
Liu, Wen
Ludeman, Emilie M.
Downton, Katherine D.
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2015-10
Volume: 23
Pages: 54-67
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2014.11.007
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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

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Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis

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