Predictors of treatment attendance and adherence to treatment recommendations among individuals receiving Cognitive Behavioral Therapy for Insomnia
Abstract
Insomnia disorders affect up to 10% of adults and are associated with other health problems and poor quality of life. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment; however, its effectiveness is hindered by poor attendance and adherence to treatment recommendations. The present study sought to identify predictors of attendance and adherence in CBT-I. Participants were 108 adults with insomnia disorder. Participants were primarily female (71.3%), middle aged (mean age = 50.5), and Caucasian (92.6%). Demographic variables, physical health problems, Beck Anxiety Inventory, Center for Epidemiologic Studies Depression-Revised scale, and Insomnia Severity Index were used to predict attending three or more sessions and adherence to consistent bedtime and waketime. Higher age was associated with better attendance and less deviation in bed and wake times. Anxiety and depression symptoms were associated with less attendance, and depression was also associated with more deviation in waketimes. To promote better attendance and adherence in treatment, depression or anxiety symptoms should be addressed before or during CBT-I. Identifying and tailoring CBT-I treatments toward the needs of different age groups may also improve attendance and adherence.
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Variables of insomnia patients that render them unsuitable for CBT-I include the severity of depression, comorbidity, and difficulties in conducting sleep restriction and stimulus control therapy.
“Variables of insomnia patients that render them unsuitable for CBT-I include the severity of depression,3 comorbidity,4 and difficulties in conducting the restriction of sleep and therapy of stimulus control.5”
From Comparison of Acceptance and Commitment Therapy (ACT) and Cognitive Behavior Therapy (CBT) for Chronic Insomnia: A Pilot Randomized Controlled Trial (2023) · cites this paper as [4]
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- Authors
- Cui, R., & Fiske, A.
- Affiliations
- West Virginia University (US)
- Corresponding author
- Fiske, Amy
- Venue
- Cognitive Behaviour Therapy
- Publisher
- Informa UK Limited
- Published
- 2019-03-14
- Volume
- 49
- Issue
- 2
- Pages
- 113-119
- ISSN
- 1650-6073 (ISSN-L)
- 1651-2316
- OpenAlex
- W2922086421
- Cited by
- 30
- References
- 13
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 1
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cognitive Behaviour Therapy (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 › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy for insomnia, treatment attendance, medication adherence, insomnia, predictors of treatment dropout, anxiety symptoms, depressive symptoms, age differences, insomnia severity
- MeSH terms
- Treatment Adherence and Compliance, Age Factors, Anxiety, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Risk Factors, Cognitive Behavioral Therapy
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