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A randomized controlled trial of cognitive behavioral therapy for insomnia: An effective treatment for comorbid insomnia and depression.
Abstract
UNLABELLED: Insomnia and depression are highly comorbid conditions that show a complex, bidirectional relationship. This study examined whether cognitive-behavioral therapy for insomnia (CBT-I) delivered by a therapist compared with self-help CBT-I (written materials only) reduces insomnia and depression severity in individuals with comorbid insomnia and depression. A total of 41 participants (18-64 years; 25 females) with comorbid depression and insomnia, treated with antidepressants for at least 6 weeks, were randomized to receive 4 sessions of either CBT-I or self-help CBT-I over 8 weeks. Insomnia (Insomnia Severity Index [ISI]) and depression (Beck Depression Inventory-II [BDI-II]) were assessed at baseline, following each session, and at 3-month follow-up. Secondary outcomes were sleep quality and duration (actigraphy and diaries), anxiety, fatigue, and daytime sleepiness. Compared with self-help CBT-I, BDI-II scores in the CBT-I group dropped by 11.93 (95% confidence interval [CI] [6.60, 17.27], p < .001) more points, and ISI scores dropped by 6.59 (95% CI [3.04, 10.15], p = .001) more points across treatment. At 3-month follow-up, 61.1% of CBT-I participants were in clinical remission from their insomnia and depression, compared with 5.6% of the self-help group. CONCLUSIONS: CBT-I administered by a therapist produced significant reductions in both insomnia and depression severity posttreatment and at follow-up, compared with a control condition in which participants received only written CBT-I material. Targeting insomnia through CBT-I is efficacious for treating comorbid insomnia and depression, and should be considered an important adjunct therapy for patients with depression whose symptoms have not remitted through antidepressant treatment.
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“There is emerging evidence that addressing insomnia in individuals with concurrent insomnia and depression improves both sleep and depression outcomes.8–10”
From Pilot evaluation of the Sleep Ninja: A smartphone application for adolescent insomnia symptoms (2019) · cites this paper as [8]
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Metadata
- Authors
- Ashworth, D. K., Sletten, T. L., Junge, M., Simpson, K., Clarke, D., Cunnington, D., & Rajaratnam, S. M. W.
- ORCID
- Venue
- Journal of Counseling Psychology
- Published
- 2015-04
- Volume
- 62
- Issue
- 2
- Pages
- 115-123
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W1977508541
- Cited by
- 131
- References
- 50
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 12 · 2023: 16 · 2022: 9 · 2021: 14 · 2020: 11 · 2019: 16 · 2018: 9 · 2017: 12 · 2016: 13 · 2015: 5
- FWCI
- 19.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Counseling Psychology (publishedVersion)
- PubMed (publishedVersion)
- 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
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy for insomnia, insomnia, depression, comorbidities, self-help intervention, sleep quality, daytime sleepiness, depression remission
- MeSH terms
- Adult, Depression, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Personality Inventory, Psychiatric Status Rating Scales, Self-Help Groups, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
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