Sleeping for Two: An Open-Pilot Study of Cognitive Behavioral Therapy for Insomnia in Pregnancy
Abstract
Insomnia and disturbed sleep are common during pregnancy. This study investigated the effectiveness of group cognitive-behavioral therapy for insomnia (CBT-I) delivered in pregnancy. Thirteen pregnant women with insomnia participated in five weekly CBT-I group sessions. All participants completed the study and provided baseline and follow-up data. Significant reductions in insomnia symptoms and increases in subjective sleep quality were observed over the course of the study. Diary and actigraphy assessments of sleep also changed, such that participants reported less time in bed (TIB), shorter sleep onset latency (SOL), increased sleep efficiency (SE), and increased subjective total sleep time (TST). Additionally, symptoms of depression, pregnancy-specific anxiety, and fatigue all decreased over the course of treatment. Effect sizes ranged from medium to large. CBT-I delivered during pregnancy was associated with significant improvements in sleep and mood. The next step in this area of inquiry is to better establish effectiveness via a randomized controlled trial.
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Preliminary evidence suggests that behavioral approaches such as cognitive behavioral therapy for insomnia (CBT-I) are efficacious in pregnancy.
“Preliminary evidence suggests that behavioral approaches such as cognitive behavioral therapy for insomnia (CBT-I) are efficacious in pregnancy [9, 10].”
From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [9]
Small open pilot studies of cognitive behavioral therapy for insomnia in pregnancy and postpartum have found large effect sizes, Cohen's d of 1.7, for improvement in the PSQI.
“Small open pilot studies of cognitive behavioral therapy for insomnia in pregnancy [9] and postpartum [23] have found large effect sizes, Cohen’s d of 1.7, for improvement in the PSQI.”
From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [9]
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- Authors
- Tomfohr-Madsen, L. M., Clayborne, Z. M., Rouleau, C. R., & Campbell, T. S.
- Affiliations
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- University of Calgary (CA)
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2016-04-28
- Volume
- 15
- Issue
- 5
- Pages
- 377-393
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- OpenAlex
- W2344555961
- Cited by
- 86
- References
- 80
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 3 · 2023: 5 · 2022: 13 · 2021: 10 · 2020: 12 · 2019: 14 · 2018: 5 · 2017: 6 · 2016: 1
- FWCI
- 12.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioral Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Calgary (10008034)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- cognitive behavioral therapy for insomnia, group therapy, sleep quality, sleep efficiency, sleep latency, actigraphy, depression, pregnancy-specific anxiety, fatigue, mood
- MeSH terms
- Adult, Affect, Anxiety, Depression, Fatigue, Female, Humans, Sleep Initiation and Maintenance Disorders, Pilot Projects, Pregnancy, Pregnancy Complications, Sleep, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Actigraphy
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