The effectiveness of behavioural and cognitive behavioural therapies for insomnia on depressive and fatigue symptoms: a systematic review and network meta-analysis
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This review aimed to assess the impact of behavioural therapy for insomnia administered alone (BT-I) or in combination with cognitive techniques (cognitive-behavioural therapy for insomnia, CBT-I) on depressive and fatigue symptoms using network meta-analysis. PubMed, Scopus and Web of Science were searched from 1986 to May 2015. Studies were included if they incorporated sleep restriction, a core technique of BT-I treatment, and an adult insomnia sample, a control group and a standardised measure of depressive and/or fatigue symptoms. Face-to-face, group, self-help and internet therapies were all considered. Forty-seven studies were included in the meta-analysis. Eleven classes of treatment or control conditions were identified in the network. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each treatment class as compared with placebo. Results showed significant effects for individual face-to-face CBT-I on depressive (d = 0.34, 95% CI: 0.06-0.63) but not on fatigue symptoms, with high heterogeneity between studies. The source of heterogeneity was not identified even after including sex, age, comorbidity and risk of bias in sensitivity analyses. Findings highlight the need to reduce variability between study methodologies and suggest potential effects of individual face-to-face CBT-I on daytime symptoms.
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Treating symptoms of insomnia also improves symptoms of depression, anxiety, and stress.
“To illustrate, treating symptoms of insomnia also improved symptoms of depression (93), anxiety, and stress (94–99).”
The effect on depression symptoms identified is comparable to the effects on depression symptoms reported in previous meta-analyses of CBT-I for insomnia.
“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 [38]
A recent network meta-analysis found that only individual, face-to-face CBT-I had a significant effect on depression symptoms when compared to a placebo condition.
“However, a recent network meta-analysis of behavioural and cognitive behavioural interventions for adults with insomnia [38] found that only individual, face-to-face CBT-I had a significant effect on depression symptoms when compared to a placebo condition.”
From The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials (2019) · cites this paper as [38]
The conclusions that could be drawn from that network meta-analysis were limited by significant heterogeneity that was not explained by the clinical, demographic or methodological characteristics examined.
“However, tThe conclusions that could be drawn from this analysis were limited by significant heterogeneity that was not explained by the clinical, demographic or methodological characteristics examined, which included age, sex, whether participants with comorbidities were excluded, and risk of bias.”
From The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials (2019) · cites this paper as [38]
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Is Brief Behavioral Treatment for Insomnia Effective?
Bootzin, R. R. (2006) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26655 · Cited by 15 · see citing works
Prävention psychischer Störungen durch kognitive Verhaltenstherapie bei Insomnie
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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 · see citing works
Blake, M. J., Trinder, J. A., & Allen, N. B. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.05.006 · Cited by 452 · see citing works
Jahrami, H., Alhaj, O. A., Humood, A. M., Alenezi, A. F., Fekih‐Romdhane, F., Al-Rasheed, M. M., Saif, Z., Bragazzi, N. L., Pandi-Perumal, S. R., BaHammam, A. S., et al. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101591 · Cited by 344 · see citing works
“…students, and special populations, such as pregnant women, etc. Evidence-based strategies, e.g., cognitive behavioral therapy for insomnia [307], meditation [308], sports interventions [309], and wellness interventions [310], can be included in self-help applications, and healthcare staff…”
Psychopathological networks: Theory, methods and practice
Bringmann, L. F., Albers, C. J., Bockting, C., Borsboom, D., Ceulemans, E., Cramer, A. O. J., Epskamp, S., Eronen, M. I., Hamaker, E. L., Kuppens, P., et al. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.104011 · Cited by 297 · see citing works
Systematic Review and Meta-analysis of Adolescent Cognitive–Behavioral Sleep Interventions
Blake, M. J., Sheeber, L. B., Youssef, G. J., Raniti, M. B., & Allen, N. B. (2017) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-017-0234-5 · Cited by 242 · see citing works
“There is also emerging evidence that CBT-I leads to improvements in physical and mental health symptoms, including reductions in anxiety and depression, with small– medium effect sizes (Ballesio et al. 2017; Belleville et al. 2011; Taylor and Pruiksma 2014).”
BackgroundBaglioni, C., Altena, E., Bjorvatn, B., Blom, K., Bothelius, K., Devoto, A., Espie, C. A., Frase, L., Gavriloff, D., Tuuliki, H., et al. (2020) · Journal of Sleep Research · doi:10.1111/jsr.12967 · Cited by 259 · see citing works
“In seven meta-analyses the efficacy of CBT-I was demonstrated for daytime or comorbid symptoms (Ballesio et al., 2018; Belleville, Cousineau, Levrier, & St. Pierre-Delorme, 2011; Ho et al., 2015; Johnson et al., 2016; Koffel et al., 2015; Tang et al., 2015; Wu et al., 2015).”
BackgroundGee, B., Orchard, F., Clarke, E., Joy, A., Clarke, T., & Reynolds, S. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.09.004 · Cited by 212 · see citing works
“However, a recent network meta-analysis of behaviou ral and cognitive behavioural interventions for adults with insomnia [38] found t ha only individual, face-to-face CBT-I had a significant effect on depression symptoms whe n compared to a placebo condition.”
BackgroundResultBlanken, T. F., Van Der Zweerde, T., Van Straten, A., Van Someren, E. J. W., Borsboom, D., & Lancee, J. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000495045 · Cited by 187 · see citing works
“In people with depression, insomnia impedes remission [3, 4], while cognitive-behavioral therapy for insomnia (CBTI) accelerates it [5, 6].”
Marx, W., Manger, S., Blencowe, M., Murray, G., Ho, F. Y., Lawn, S., Blumenthal, J. A., Schuch, F. B., Stubbs, B., Ruusunen, A. A., et al. (2022) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2022.2112074 · Cited by 189 · see citing works
“Three recent systematic reviews have investigated the antidepressant effects of CBT-I amongst people diagnosed with insomnia and subsyndromal depressive symptoms (Ballesio et al. 2018; Benz et al. 2020; Ho et al. 2020).”
BackgroundMitchell, L. J., Bisdounis, L., Ballesio, A., Omlin, X., & Kyle, S. D. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.06.002 · Cited by 171 · see citing works
Efficacy of cognitive behavioral therapy for insomnia in breast cancer: A meta-analysis
Ma, Y., Hall, D. L., Ngo, L. H., Liu, Q., Bain, P. A., & Yeh, G. Y. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101376 · Cited by 151 · see citing works
Interventions for sleep problems during pregnancy: A systematic review
Bacaro, V., Benz, F., Pappaccogli, A., Bartolo, P. D., Johann, A. F., Palagini, L., Lombardo, C., Feige, B., Riemann, D. W., & Baglioni, C. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.101234 · Cited by 145 · see citing works
Benz, F., Knoop, T., Ballesio, A., Bacaro, V., Johann, A. F., Rücker, G., Feige, B., Riemann, D., & Baglioni, C. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101873 · Cited by 142 · see citing works
Rios, P. D. L., Cardoso, R., Morra, D. E., Nincic, V., Goodarzi, Z., Farah, B., Harricharan, S., Morin, C. M., Leech, J. A., Straus, S. E., et al. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1163-9 · Cited by 141 · see citing works
Thakral, M., Von Korff, M., McCurry, S. M., Morin, C. M., & Vitiello, M. V. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.101230 · Cited by 117 · see citing works
“We also reviewed the reference lists of 5 review articles (1,4,31,32).”
van der Zweerde, T., van Straten, A., Effting, M., Kyle, S. D., & Lancee, J. (2018) · Psychological Medicine · doi:10.1017/s0033291718001149 · Cited by 109 · see citing works
Arnedt, J. T., Conroy, D. A., Mooney, A., Furgal, A. K. C., Sen, A., & Eisenberg, D. (2020) · SLEEP · doi:10.1093/sleep/zsaa136 · Cited by 109 · see citing works
Ballesio, A., Bacaro, V., Vacca, M., Chirico, A., Lucidi, F., Riemann, D., Baglioni, C., & Lombardo, C. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101378 · Cited by 87 · see citing works
Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature
Wynchank, D., Bijlenga, D., Beekman, A. T. F., Kooij, J. J. S., & Penninx, B. W. J. H. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0860-0 · Cited by 84 · see citing works
Kyle, S. D., Hurry, M. E. D., Emsley, R., Marsden, A., Omlin, X., Juss, A., Spiegelhalder, K., Bisdounis, L., Luik, A. I., Espie, C. A., et al. (2020) · SLEEP · doi:10.1093/sleep/zsaa034 · Cited by 81 · see citing works
Huberty, J. L., Green, J., Puzia, M. E., Larkey, L., Laird, B., Vranceanu, A.-M., Vlisides-Henry, R., & Irwin, M. R. (2021) · PLOS ONE · doi:10.1371/journal.pone.0244717 · Cited by 73 · see citing works
“Additionally, up to 10% of adults reporting sleep disturbances have severe and chronic symptoms that meet diagnostic criteria for insomnia [9], with fatigue being one of the most frequent complaints [10].”
Backgroundvan der Zweerde, T., Lancee, J., Slottje, P., Bosmans, J. E., Someren, E. J. W. V., & van Straten, A. (2020) · Psychotherapy and Psychosomatics · doi:10.1159/000505600 · Cited by 76 · see citing works
The Sleep Condition Indicator: reference values derived from a sample of 200 000 adults
Espie, C. A., Machado, P. F., Carl, J. R., Kyle, S. D., Cape, J. D., Siriwardena, A. N., & Luik, A. I. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12643 · Cited by 75 · see citing works
“Previous research has supported the use of a cut-off of 16 for possible insomnia disorder (Ballesio et al., 2017; Bayard et al., 2017; Espie et al., 2014b; Palagini et al., 2015; Wong et al., 2017).”
MethodPrevention of internalizing disorders and suicide via adolescent sleep interventions
Blake, M. J., & Allen, N. B. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.08.027 · Cited by 66 · see citing works
Blake, M. J., Snoep, L., Raniti, M. B., Schwartz, O., Waloszek, J. M., Simmons, J. G., Murray, G., Blake, L. M., Landau, E. R., Dahl, R. E., et al. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.10.006 · Cited by 65 · see citing works
“Cognitive-behavioral therapy for insomnia (CBT-I) is recommended as a front-line treatment for adult insomnia (Qaseem, Kansagara, Forciea, Cooke, & Denberg, 2016), based on evidence from multiple systematic reviews and meta-analyses that the intervention improves sleep and mental health in adults, usually with medium-…”
BackgroundCadegiani, F., & Kater, C. E. (2018) · Journal of Sports Sciences · doi:10.1080/02640414.2018.1424498 · Cited by 61 · see citing works
“Sleep disturbances may play triggering, worsening, and perpetuating roles in OTS, since lack of sleep quality reduces several reparative mechanisms and, at the same time, fatigue induces a worsening in sleep quality (Ballesio et al., 2018; Mulla et al., 2017).”
BackgroundKalmbach, D. A., Cheng, P., Arnedt, J. T., Cuamatzi-Castelan, A., Atkinson, R. L., Fellman-Couture, C., Roehrs, T., & Drake, C. L. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7882 · Cited by 58 · see citing works
Blake, M. J., Schwartz, O., Waloszek, J. M., Raniti, M. B., Simmons, J. G., Murray, G., Blake, L. M., Dahl, R. E., Bootzin, R. R., McMakin, D. L., et al. (2017) · SLEEP · doi:10.1093/sleep/zsx061 · Cited by 57 · see citing works
Blake, M. J., Blake, L. M., Schwartz, O., Raniti, M. B., Waloszek, J. M., Murray, G., Simmons, J. G., Landau, E. R., Dahl, R. E., McMakin, D. L., et al. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12842 · Cited by 57 · see citing works
“intervention improves sleep and mental health in adults, usually with medium-large effect sizes (Ballesio et al., 2017; Taylor & Pruiksma, 2014; Trauer, Qian, Doyle, Rajaratnam, & Cunnington, 2015; Van Straten et al., 2017).”
BackgroundLiving with persistent insomnia after cancer: A qualitative analysis of impact and management
Reynolds‐Cowie, P., & Fleming, L. (2021) · British Journal of Health Psychology · doi:10.1111/bjhp.12446 · Cited by 53 · see citing works
“…behavioural therapy for insomnia (CBT-i) has accumulated a substantial evidence base as an efficacious and durable therapy for insomnia (Ballesio et al., 2018) and is nowwidely regarded as the gold standard treatment for persistent insomnia in the general population (Ballesio et al., 2018).”
BackgroundInfluentialWynchank, D., ten Have, M., Bijlenga, D., Penninx, B. W., Beekman, A. T., Lamers, F., de Graaf, R., & Kooij, J. J. S. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6976 · Cited by 51 · see citing works
“56,57 Such treat - ments could be used to ameliorate the sleep disturbance we have found to be so prevalent in ADHD.”
The Psychological Experience and Intervention in Post-Acute COVID-19 Inpatients
Ferrario, S. R., Panzeri, A., Cerutti, P., & Sacco, D. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s283558 · Cited by 48 · see citing works
Gender‐specific differences in parental health‐related quality of life in childhood cancer
Rensen, N., Steur, L. M. H., Schepers, S. A., Merks, J. H. M., Moll, A. C., Kaspers, G. J. L., Grootenhuis, M. A., & van Litsenburg, R. R. L. (2019) · Pediatric Blood & Cancer · doi:10.1002/pbc.27728 · Cited by 48 · see citing works
Bianchi, M. L., Cornejo, F. A., Fresno, A., Rojas, C., & Serrano, C. (2017) · Gaceta Sanitaria · doi:10.1016/j.gaceta.2017.07.018 · Cited by 47 · see citing works
Chan, C. S., Wong, C. Y.-F., Yu, B. Y., Hui, V. K., Ho, F. Y., & Cuijpers, P. J. (2021) · Psychological Medicine · doi:10.1017/s0033291721003421 · Cited by 42 · see citing works
Testing the contiguity of the sleep and fatigue relationship: a daily diary study
Harris, A. L., Carmona, N. E., Moss, T. G., & Carney, C. E. (2021) · Sleep · doi:10.1093/sleep/zsaa252 · Cited by 42 · see citing works
Osnes, R. S., Eberhard‐Gran, M., Follestad, T., Kallestad, H., Morken, G., & Roaldset, J. O. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2020.1743705 · Cited by 39 · see citing works
A dynamic attentional control framework for understanding sleep deprivation effects on cognition
Whitney, P. J., Hinson, J. M., & Nusbaum, A. T. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2019.03.015 · Cited by 40 · see citing works
“The maintenance and updating neural circuits are dissociable, and performance depends on the correct circuit taking precedence in the correct context (see Barkley, 2012; Braver, 2012; Nigg, 2017 for reviews).”
BackgroundGiollabhui, N. M. (2021) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2021.100278 · Cited by 38 · see citing works
“The importance of these risk factors in the etiology and maintenance of depression is outlined in multiple systematic reviews identifying smoking cessation, increased exercise, improved diet/nutrition and sleep as effective interventions for depression (Ballesio et al., 2018; Jacka et al., 2017; Kvam et al., 2016; Lop…”
BackgroundJi, X., Bastien, C. H., Ellis, J. G., Hale, L., & Grandner, M. A. (2019) · Sleep Health · doi:10.1016/j.sleh.2018.12.009 · Cited by 37 · see citing works
Hashash, J. G., Knisely, M. R., Germain, A., McAuliff, K., Strassburger, M., Vachon, A., Binion, D. G., Regueiro, M., Wallace, M., & Szigethy, E. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.09.047 · Cited by 37 · see citing works
It is time to investigate integrative approaches to enhance treatment outcomes for depression?
Lopresti, A. L. (2019) · Medical Hypotheses · doi:10.1016/j.mehy.2019.03.008 · Cited by 37 · see citing works
“For example, in people with comorbid depression and insomnia, findings from two meta-analyses confirm that CBT for insomnia effectively reduces comorbid insomnia and depressive symptoms [86,87].”
BackgroundDoremus, J. M., Stith, S. S., & Vigil, J. M. (2019) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2019.102207 · Cited by 34 · see citing works
Koffel, E., Amundson, E. C., Polusny, G., & Wisdom, J. P. (2019) · Behavioral Sleep Medicine · doi:10.1080/15402002.2019.1591958 · Cited by 33 · see citing works
“…widespread benefits, leading to reductions in depression, inflammation, risk of chronic health conditions, and reliance on sedative-hypnotics (Ballesio et al., 2018; Irwin et al., 2014; Park et al., 2018; Tang CONTACT Erin Koffel Erin.Koffel@va.gov Center for Care Delivery and Outcomes…”
BackgroundHall, D. L., Arditte Hall, K. A., Gorman, M. J., Comander, A., Goldstein, M. R., Cunningham, T. J., Wieman, S., Mizrach, H. R., Juhel, B. C., Li, R., et al. (2022) · Cancer · doi:10.1002/cncr.34066 · Cited by 31 · see citing works
Ma, C., Deng, Y., Xiao, R., Xu, F., Li, M., Gong, Q., & Gao, J. (2021) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2021.174563 · Cited by 32 · see citing works
Inflammatory hypotheses of sleep disturbance - depression link: Update and research agenda
Ballesio, A. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100647 · Cited by 34 · see citing works
Xu, C., Furuya‐Kanamori, L., Kwong, J. S. W., Li, S., Liu, Y., & Doi, S. A. R. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101434 · Cited by 30 · see citing works
Boland, E. M., Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.033 · Cited by 29 · see citing works
“Nevertheless, our findings are in line with burgeoning research showing that insomnia treatment is associated with improvements in depressive symptoms (Ballesio et al., 2018; Cunningham & Shapiro, 2018; Gebara et al., 2018b).”
ResultInternet-Delivered Cognitive Behavioral Therapy for Insomnia
van der Zweerde, T., Lancee, J., Luik, A. I., & van Straten, A. (2020) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2020.02.001 · Cited by 30 · see citing works
Ballesio, A., Zagaria, A., Vacca, M., Pariante, C. M., & Lombardo, C. (2023) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2023.05.006 · Cited by 29 · see citing works
“When the number of articles included in the NMA did not suffice the use of psychoeducation as a control, we considered placebo as the reference condition (Ballesio et al., 2018).”
Johann, A. F., Hertenstein, E., Feige, B., Akram, U., Holub, F., Baglioni, C., Domschke, K., Schramm, E., Nissen, C., Kyle, S. D., et al. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13102 · Cited by 30 · see citing works
“T0 and T1 data for subjective sleep-related and psychopathology-related outcomes are presented in Table 2 and Table S2, illustrating a high treatment efficacy (d = −1.3) comparable to meta-analytical data of CBT-I effects (Ballesio et al., 2018; van Straten et al., 2018).”
ResultInfluentialWang, S., Lan, Y., Liu, Z., Xu, S., & Wu, X. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.07.004 · Cited by 29 · see citing works
Fordham, B., Sugavanam, T., Hopewell, S., Hemming, K., Howick, J., Kirtley, S., das Nair, R., Hamer-Hunt, J., & Lamb, S. E. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-025761 · Cited by 27 · see citing works
Alikhani, M., Ebrahimi, A., Farnia, V., Khazaie, H., Radmehr, F., Mohamadi, E., Davarinejad, O., Dürsteler, K. M., Bahmani, D. S., & Brand, S. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.07.043 · Cited by 27 · see citing works
Brown, R. F., Thorsteinsson, E., Smithson, M. J., Birmingham, C. L., Aljarallah, H., & Nolan, C. J. (2017) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-017-0439-0 · Cited by 25 · see citing works
Sandlund, C., Hetta, J. E., Nilsson, G. H., Ekstedt, M., & Westman, J. (2018) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2018.05.002 · Cited by 27 · see citing works
Wilson, N., Wynter, K. H., Anderson, C., Rajaratnam, S. M. W., Fisher, J., & Bei, B. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2024-8 · Cited by 25 · see citing works
“Women in the postpartum period with elevated fatigue, stress, and insomnia could potentially benefit from existing evidence-based interventions such as stress reduction, fatigue management, and cognitive behavior therapy for insomnia [53, 81, 93, 94].”
BackgroundDyrberg, H., Juel, A., & Kragh, M. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2020.1788033 · Cited by 25 · see citing works
“Research supports the efficacy of CBT-I for patients with depression (Ballesio et al., 2018; Cunningham & Shapiro, 2018; Gebara et al., 2018).”
MethodExploring the Meaning of Cognitive Behavioral Therapy for Insomnia for Patients with Chronic Pain
Koffel, E., Amundson, E. C., & Wisdom, J. P. (2019) · Pain Medicine · doi:10.1093/pm/pnz144 · Cited by 25 · see citing works
“This aligns with quantitative work suggesting that CBT-I provides widespread benefits beyond sleep, including improvements in mood and energy.(10, 17, 46) Moreover, it supports previous findings that behavioral sleep interventions lead to more robust improvements in Koffel et al.”
ResultCross-Cultural Validation of the Korean Version of the Chalder Fatigue Scale
Ha, H., Jeong, D., Hahm, B., & Shim, E. (2017) · International Journal of Behavioral Medicine · doi:10.1007/s12529-017-9701-0 · Cited by 25 · see citing works
“In a related matter, in a recent systematic review of the effectiveness of cognitive behavioral therapies for insomnia (CBTI), fatigue symptoms only partially improved while depressive symptoms were effectively reduced after CBT-I, suggesting that fatigue may be a residual symptoms of insomnia [12].”
Kodsi, A., Bullock, B., Kennedy, G. A., & Tirlea, L. (2022) · Behavioral Sleep Medicine · doi:10.1080/15402002.2021.1876062 · Cited by 23 · see citing works
Lai, H., Chen, C., Lu, C., & Huang, C. (2021) · Brain Sciences · doi:10.3390/brainsci11121614 · Cited by 23 · see citing works
Zhao, W., Someren, E. J. W. V., Xu, Z., Ren, Z., Tang, L., Li, C., & Lei, X. (2023) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2023.112276 · Cited by 23 · see citing works
Psychological correlates of insomnia in professional soccer players: An exploratory study
Ballesio, A., Vacca, M., Bacaro, V., Benazzi, A., Bartolo, P. D., Alivernini, F., Lucidi, F., Lombardo, C., & Baglioni, C. (2021) · European Journal of Sport Science · doi:10.1080/17461391.2021.1892197 · Cited by 22 · see citing works
“Particularly, CBT-I is a multicomponent treatment consisting of behavioural strategies such stimulus control therapy and sleep restriction therapy aimed at increasing sleep pressure and sleepinducing routines, cognitive strategies such as cognitive restructuring of dysfunctional sleep-related thoughts as well as psych…”
MethodInfluentialZhao, N., Zhao, Y.-J., An, F., Zhang, Q., Sha, S., Su, Z., Cheung, T. C. C., Jackson, T., Zang, Y., & Xiang, Y. (2023) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10586 · Cited by 22 · see citing works
López, C. M., Lancaster, C. L., Wilkerson, A. K., Grös, D. F., Ruggiero, K. J., & Acierno, R. E. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.01.006 · Cited by 22 · see citing works
Cognitive Behavioral Therapies for Insomnia and Hypnotic Medications
Cheung, J. M. Y., Ji, X., & Morin, C. M. (2019) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2019.01.006 · Cited by 22 · see citing works
Kuhlman, K. R., Chiang, J. J., Bower, J. E., Irwin, M. R., Cole, S. W., Dahl, R. E., Almeida, D. M., & Fuligni, A. J. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00581-y · Cited by 22 · see citing works
Salari, N., Jafari, S., Darvishi, N., Valipour, E., Mohammadi, M., Mansouri, K., & Shohaimi, S. (2021) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-021-00733-5 · Cited by 21 · see citing works
RetractedLin, W., Li, N., Yang, L., & Zhang, Y. (2023) · PeerJ · doi:10.7717/peerj.16137 · Cited by 22 · see citing works
Perach, R., Allen, C. K., Kapantai, I., Madrid‐Valero, J. J., Miles, E., Charlton, R. A., & Gregory, A. M. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.09.003 · Cited by 20 · see citing works
Rensen, N., Steur, L. M. H., Grootenhuis, M. A., van Eijkelenburg, N. K. A., van der Sluis, I. M., Dors, N., van den Bos, C., Tissing, W. J. E., Kaspers, G. J. L., & van Litsenburg, R. R. L. (2020) · Pediatric Blood & Cancer · doi:10.1002/pbc.28697 · Cited by 19 · see citing works
Regli, J., Bahmani, D. S., Rigotti, V., Stanga, Z. G., Ülgür, I. I., Fichter, C., Lang, U. E., Brühl, A. B., & Brand, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154372 · Cited by 20 · see citing works
“To make the case in point, successfully treating symptoms of insomnia also improved symptoms of depression, anxiety, and stress [43,66,136,148–150].”
BackgroundCognitive behavioural therapy for insomnia reduces ruminative thinking
Ballesio, A., Devoto, A., & Lombardo, C. (2018) · Sleep and Biological Rhythms · doi:10.1007/s41105-018-0168-4 · Cited by 19 · see citing works
“The use of self-help CBT-I as a control condition was chosen since this type of treatment is associated with limited effectiveness when compared to individual CBT-I [5].”
MethodSasaki, N., Yasuma, N., Obikane, E., Narita, Z. C., Sekiya, J., Inagawa, T., Nakajima, A., Yamada, Y., Yamazaki, R., Matsunaga, A., et al. (2020) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12155 · Cited by 19 · see citing works
“CBT-I has been shown to be effective for reducing depressive symptoms not only among people with insomnia in general [35-39], but also among postpartum women with insomnia [40], although research on cognitive-behavioral sleep interventions is still in its infancy.”
BackgroundBuffart, L. M., Schreurs, M. A. C., Abrahams, H. J. G., Kalter, J., Aaronson, N. K., Jacobsen, P. B., Newton, R. U., Courneya, K. S., Armes, J., Arving, C., et al. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101882 · Cited by 19 · see citing works
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Assessing Sleep Quality Using Mobile EMAs: Opportunities, Practical Consideration, and Challenges
Lim, J., Jeong, C. Y., Lim, J. M., Chung, S., Kim, G., Noh, K. J., & Jeong, H. (2022) · IEEE Access · doi:10.1109/access.2021.3140074 · Cited by 17 · see citing works
“Exercise is also known to affect sleep quality and its effects have been studied on patients with sleep disorders [14], [15].”
BackgroundAlitalo, O., Saarreharju, R., Henter, I. D., Zarate, C. A., Kohtala, S., & Rantamäki, T. (2021) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2021.102140 · Cited by 16 · see citing works
“Indeed, emerging evidence has indicated that depressive symptoms can be alleviated by normalizing patients’ circadian misalignment and improving sleep quality (Ballesio et al., 2018; Cheng et al., 2019; Kalmbach et al., 2019; Manber et al., 2008; McCall et al., 2010).”
Plants Alkaloids Based Compound as Therapeutic Potential for Neurodegenerative
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“This is even more justified in that there are proven and standardized psychotherapeutic interventions to improve sleep, such as: (i) insomnia-specific CBT interventions, either in vivo [69– 76] or via online tools (CBT-i: Refs.”
BackgroundTinnitus: psychosomatische Aspekte
Boecking, B., Brüeggemann, P., & Mazurek, B. (2019) · HNO · doi:10.1007/s00106-019-0609-7 · Cited by 15 · see citing works
Therapy for insomnia with chronic obstructive pulmonary disease: a randomized trial of components
Kapella, M. C., Steffen, A. D., Prasad, B., Laghi, F. A., Vispute, S., Kemner, G., Teixeira, C., Peters, T. A., Jun, J., Law, J., et al. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10210 · Cited by 14 · see citing works
Internet-Delivered Cognitive Behavioral Therapy for Insomnia
van der Zweerde, T., Lancee, J., Luik, A. I., & van Straten, A. (2019) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2019.04.002 · Cited by 14 · see citing works
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Tse, K. Y. K., Maurer, L. F., Espie, C. A., & Kyle, S. D. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14180 · Cited by 12 · see citing works
Jernelöv, S., Forsell, E., Kaldo, V., & Blom, K. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.676962 · Cited by 13 · see citing works
“Indeed, it has been shown that cognitive behavioral therapy for insomnia (CBT-I) may alleviate depression (11), also for those patients suffering from both diagnoses (12).”
BackgroundSalwen‐Deremer, J. K., Siegel, C. A., & Smith, M. T. (2020) · Crohn s & Colitis 360 · doi:10.1093/crocol/otaa052 · Cited by 15 · see citing works
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Knutzen, S. M., Christensen, D. S., Cairns, P., Damholdt, M. F., Amidi, A., & Zachariae, R. H. (2024) · JMIR Mental Health · doi:10.2196/58217 · Cited by 14 · see citing works
“…add to the more general findings that CBTI may not only improve insomnia itself but also associated psychological and physical symptoms such as depression, anxiety, and fatigue [96-98], with our findings indicating that both delivery formats appear equally efficacious in reducing these symptoms.”
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The relation between insomnia and depression in the subacute phase after stroke
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“As far as treatment is concerned, cognitive behavioural therapy for insomnia (CBT-I) lowered depression symptomatology in the general population (Ballesio et al., 2018; Van der Zweerde et al., 2019).”
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Treating insomnia in patients with comorbid psychiatric disorders: A focused review.
Garland, S. N., Vargas, I., Grandner, M. A., & Perlis, M. L. (2018) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000141 · Cited by 11 · see citing works
“In a network meta-analysis of 47 RCTs of behavioral and cognitive therapies for insomnia that included populations with an identified psychiatric disorder, treatment with individual CBT-I was associated with a medium effect size (d 46) for reducing associated depressive symptoms (Ballesio et al., 2018).”
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“10,11 In the United States, average combined direct and indirect costs are an additional $1253 per annum for young and middle-aged adults, and $1143 per annum for adults over 65 with insomnia, compared to individuals without insomnia.”
Takano, Y., Ibata, R., Machida, N., & Okajima, I. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.07.008 · Cited by 9 · see citing works
Walsh, R. F. L., Maddox, M. A., Smith, L. T., Olino, T. M., Zee, P. C., Nusslock, R., & Alloy, L. B. (2025) · Journal of Sleep Research · doi:10.1111/jsr.14468 · Cited by 11 · see citing works
“…times is a central component of cognitive behavioural therapy for insomnia (Morin et al., 2006) (Sarfan et al., 2023), and fortunately, there is substantial evidence that these sleep-focussed treatments also help to reduce depression (Ballesio et al., 2018) and anxiety (Belleville et al., 2011).”
Dyrberg, H., Bjorvatn, B., & Larsen, E. R. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11195845 · Cited by 9 · see citing works
- Authors
- Ballesio, A., Aquino, M. R. J. V., Feige, B., Johann, A. F., Kyle, S. D., Spiegelhalder, K., Lombardo, C., Rücker, G., Riemann, D., & Baglioni, C.
- Affiliations
- Sapienza University of Rome (IT)
- City, University of London (GB)
- University of Freiburg (DE)
- University of Oxford (GB)
- Corresponding author
- Baglioni, Chiara
- ORCID
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 37
- Pages
- 114-129
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2587622674
- Cited by
- 172
- References
- 100
- Citations by year
- 2026: 16 · 2025: 17 · 2024: 16 · 2023: 16 · 2022: 15 · 2021: 24 · 2020: 21 · 2019: 25 · 2018: 13 · 2017: 9
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, other-oa)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Funders
- University Medical Center of Freiburg, Germany
- Sapienza University of Rome, Italy
- 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
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- insomnia, cognitive behavioral therapy for insomnia, depression, fatigue, sleep restriction, online therapy, group therapy, self-help intervention, face-to-face therapy, daytime symptoms
- MeSH terms
- Depression, Fatigue, Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy
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