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Changes in dysfunctional beliefs about sleep after cognitive behavioral therapy for insomnia: A systematic literature review and meta-analysis
Open accessAbstract
Cognitive behavioral therapy for insomnia (CBT-I) is the preferred treatment for chronic insomnia and sleep-related cognitions are one target of treatment. There has been little systematic investigation of how sleep-related cognitions are being assessed in CBT-I trials and no meta-analysis of the impact of CBT-I on dysfunctional beliefs about sleep, a core cognitive component of treatment. Academic Search Complete, Medline, CINAHL and PsychInfo from 1990 to 2018 were searched to identify randomized controlled trials of CBT-I in adults (≥18 years) reporting some measure of sleep-related cognitions. Sixteen randomized controlled trials were identified comparing 1134 CBT-I and 830 control subjects. The Dysfunctional Beliefs and Attitudes about Sleep Scale was utilized almost exclusively to assess sleep-related cognitions in these trials. Hedge's g at 95% confidence interval (CI) was calculated to assess CBT-I effect size at post-treatment compared to controls. CBT-I significantly reduced dysfunctional beliefs about sleep (g = -0.90, 95% CI -1.19, -0.62) at post-treatment. Three trials contributed data to estimate effect size for long-term effects (g = -1.04, 95% CI -2.07, -0.02) with follow up time ranging from 3 to 18 mo. We concluded that cognitive behavioral therapy for insomnia has moderate to large effects on dysfunctional beliefs about sleep.
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“a meta-analysis by Thakral et al. (2020) found dysfunctional beliefs and attitudes about sleep improve after a period of CBT-I in adults, with a large effect reported.”
From Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis (2022) · cites this paper as Thakral et al., 2020
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“This reflects a similar meta-analysis investigating the effects of CBT-I on dysfunctional beliefs and attitudes about sleep, where a large effect was found (Thakral et al., 2020).”
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Metadata
- Authors
- Thakral, M., Von Korff, M., McCurry, S. M., Morin, C. M., & Vitiello, M. V.
- Affiliations
- University of Washington (US)
- Université Laval (CA)
- Corresponding author
- Thakral, Manu
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 49
- Pages
- 101230
- ISSN
- 1087-0792 (ISSN-L)
- PMC
- PMC7012685
- OpenAlex
- W2985404547
- Cited by
- 117
- References
- 75
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 13 · 2023: 28 · 2022: 25 · 2021: 10 · 2020: 5
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy for insomnia, dysfunctional beliefs about sleep, sleep-related cognitions, chronic insomnia, treatment effect size, long-term follow-up
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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