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The effectiveness of behavioural and cognitive behavioural therapies for insomnia on depressive and fatigue symptoms: A systematic review and network meta-analysis
Open accessAbstract
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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“To illustrate, treating symptoms of insomnia also improved symptoms of depression (93), anxiety, and stress (94–99).”
In the citing paper
“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]
In the citing paper
“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]
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“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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Citations
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“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).”
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“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.”
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“In people with depression, insomnia impedes remission [3, 4], while cognitive-behavioral therapy for insomnia (CBTI) accelerates it [5, 6].”
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“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
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
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 152
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
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van der Zweerde, T., van Straten, A., Effting, M., Kyle, S. D., & Lancee, J. (2018) · Psychological Medicine · doi:10.1017/s0033291718001149 · Cited by 109
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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
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 90
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 85
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“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].”
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“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 70
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 71
“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
“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
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 64
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 66
“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
“…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
“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
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
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 50
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 43
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
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
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 42
“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
“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
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
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 40
“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].”
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Koffel, E., Amundson, E. C., Polusny, G., & Wisdom, J. P. (2019) · Behavioral Sleep Medicine · doi:10.1080/15402002.2019.1591958 · Cited by 37
“…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
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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 35
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
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
“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
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 30
“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 33
“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
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
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
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
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
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
“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
“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
“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
“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
Lai, H., Chen, C., Lu, C., & Huang, C. (2021) · Brain Sciences · doi:10.3390/brainsci11121614 · Cited by 23
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 24
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 24
“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
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 24
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 25
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 23
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 24
RetractedLin, W., Li, N., Yang, L., & Zhang, Y. (2023) · PeerJ · doi:10.7717/peerj.16137 · Cited by 24
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 22
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 21
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
“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
“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
“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
Andreu‐Caravaca, L., Ramos‐Campo, D. J., Abellán‐Aynés, O., Ávila-Gandía, V., Chung, L. H., Manonelles, P., & Rubio‐Arias, J. Á. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1934738 · Cited by 20
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 18
“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 17
“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
Patel, R. K., Gangwar, D., Gupta, H., Sharma, N., & Kumar, R. (2023) · Journal for Research in Applied Sciences and Biotechnology · doi:10.55544/jrasb.2.2.3 · Cited by 15
Bahmani, D. S., Parhoon, H., Esmaeili, M., Parhoon, K., Bahmani, L. S., Khazaie, H., Becker, S. P., Burns, G., & Brand, S. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12144607 · Cited by 14
“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
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
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
Lebrun, C., Gély-Nargeot, M.-C., Maudarbocus, K. H., & Bayard, S. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2018.1546178 · Cited by 12
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
Jernelöv, S., Forsell, E., Kaldo, V., & Blom, K. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.676962 · Cited by 16
“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 16
Ho, F. Y., Choi, W.-T., Yeung, W., Lam, H.-K., Lau, W., & Chung, K. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.08.024 · Cited by 13
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
“…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.”
BackgroundTurkowitch, D., Ludwig, R. L., Nelson, E., Drerup, M. L., & Siengsukon, C. F. (2022) · Multiple Sclerosis International · doi:10.1155/2022/7110582 · Cited by 12
The relation between insomnia and depression in the subacute phase after stroke
Geusgens, C. A. V., van Tilburg, D. C. H., Fleischeuer, B., & Bruijel, J. (2024) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2370072 · Cited by 10
“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).”
Bahmani, D. S., Eisenhut, L., Mikoteit, T., Helfenstein, N., Brühl, A. B., Dürsteler, K. M., Becker, S. P., & Brand, S. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14072362 · Cited by 14
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 12
“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).”
Lau, P. H., Carney, A. E., Marway, O. S., Carmona, N. E., Amestoy, M. E., & Carney, C. E. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100366 · Cited by 12
Scott, A. M., Peiris, R., Atkins, T., Cardona, M., Greenwood, H., Clark, J., & Glasziou, P. (2025) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x231204071 · Cited by 11
“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
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
“…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 10
Metadata
- 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
- 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 (medical) › 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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