The Impact of Cognitive-Behavioral Interventions on Sleep Disturbance in Depressed and Anxious Community-dwelling Older Adults: A Systematic Review
Open accessAbstract
INTRODUCTION: Depression and anxiety are prevalent mental health conditions in older adulthood. Despite sleep disturbance being a common comorbidity in late-life depression and anxiety, it is often discounted as a target for treatment. The current review aims to establish whether cognitive-behavioral therapy (CBT) is effective in treating concomitant sleep disturbance in depressed and anxious older adults and to review evidence supporting whether CBT interventions targeting anxiety and depression, or concurrent sleep disturbance, have the greatest effectiveness in this client group. METHOD: A systematic database search was conducted to identify primary research papers evaluating the effectiveness of CBT interventions, recruiting older adults with symptoms of depression and/or anxiety, and employing a validated measure of sleep disturbance. The identified papers were included in a narrative synthesis of the literature. RESULTS: Eleven identified studies consistently support reductions in sleep disturbance in elderly participants with depression and anxiety in response to CBT. Most CBT interventions in the review included techniques specifically targeting sleep, and only one study directly compared CBT for insomnia (CBT-I) with a CBT-I intervention also targeting depressive symptoms, limiting the ability of the review to comment on whether interventions targeting sleep disturbance or mental health symptoms have superior effectiveness. CONCLUSION: The extant research indicates that CBT interventions are effective in ameliorating sleep disturbance in late-life depression and anxiety. Future high-quality research is required to substantiate this finding and to compare the effectiveness of CBT-I and CBT for depression and anxiety in this group to inform clinical practice.
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Mindfulness-based interventions significantly alleviated insomnia severity and depression, reduced pre-sleep rumination, and decreased physiological arousal, thereby improving sleep outcomes.
“RCTs further indicate that mindfulness-based interventions significantly alleviated insomnia severity and depression, reduced pre-sleep rumination, and decreased physiological arousal, thereby improving sleep outcomes [77].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [77]
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- Authors
- Bentham, C., & Eaves, L.
- Affiliations
- University of Sheffield (GB)
- Sheffield Teaching Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Bentham, Charlotte
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2021-06-14
- Volume
- 20
- Issue
- 4
- Pages
- 477-499
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- OpenAlex
- W3171421740
- Cited by
- 20
- References
- 62
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 6 · 2023: 1
- FWCI
- 0.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Behavioral Sleep Medicine (publishedVersion, cc-by-nc-nd)
- 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, sleep disorders, insomnia, geriatric depression, late-life anxiety, older adults, comorbid depression and anxiety, community-dwelling older adults
- MeSH terms
- Aged, Anxiety, Cognition, Depression, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Cognitive Behavioral Therapy, Treatment Outcome, Independent Living
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