Quality of Life Improvements after Acceptance and Commitment Therapy in Nonresponders to Cognitive Behavioral Therapy for Primary Insomnia
Abstract
years; no relevant comorbidities). All participants had extensive experience with CBT-I according to evidence-based guidelines ( ≥ 6 sessions; period of time between CBT-I and inclusion in the present study: 2.2 ± 3.4 years) and continued suffering from clini-cally relevant insomnia (sleep onset latency or wake time after sleep onset: ≥30 min, ≥3 days/week). Seven participants were free of psychoactive medication; 3 had been on stable medication for ≥ 3 years. All participants were diagnosed in our sleep laboratory based on a clinical interview and standard physical examinations and provided written informed consent prior to the study. The study has been approved by the local ethics committee and has been registered in the German Clinical Trials Register prior to the enrollment of the first participant. The open pilot study comprised 2 baseline measurements [6 weeks before (T
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A pilot study previously demonstrated a substantial enhancement in sleep-related quality of life and subjective sleep quality in individuals with chronic primary insomnia who did not respond to CBT-I, immediately after completing six weekly outpatient sessions of ACT and at the 3-month follow-up.
“A pilot study conducted previously demonstrated a substantial enhancement in sleep-related quality of life and subjective sleep quality in individuals with chronic primary insomnia who did not respond to CBT-I, immediately after completing six weekly outpatient sessions of ACT and at the 3-month follow-up.22”
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 [22]
ACT has been shown as effective in improving sleep quality and quality of life in non-autistic, CBT-I non-responders.
“ACT has been shown as effective in improving sleep quality and quality of life in non-autistic, CBT-I non-responders (Dalrymple et al ., 2010; Hertenstein et al ., 2014).”
From ACT-i, an insomnia intervention for autistic adults: A pilot study (2023) · cites this paper as Hertenstein et al., 2014
ACT-BBI-I has shown favorable results in preliminary studies with participants refractory to CBT-I.
“ACT-BBI-I has shown favorable results in preliminary studies5,7 with participants refractory to CBT-I.”
From Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial (2021) · cites this paper as [5]
Similar results were found by Dalrymple et al. and Hertenstein et al.
“Similar results were found by Dalrymple et al.7 and Hertenstein et al.5”
From Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial (2021) · cites this paper as [5]
Our finding that integrating ACT principles with traditional behavioral techniques of CBT-I is also effective for insomnia is consistent with certain other studies in this field.
“Our finding that integrating ACT principles with traditional behavioral techniques of CBT-I is also effective for insomnia and is consistent with certain other studies in this field.5-7”
From Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial (2021) · cites this paper as [5]
This finding is aligned with the findings reported in Hertenstein et al. (2014) on quality of life improvements after ACT in nonresponders to CBT for primary insomnia.
“Also, their responses indicated that awareness of their thoughts and feelings seemed to have improved the overall quality of their lives, which is aligned with the findings reported in the study of the Quality of Life Improvements after Acceptance and Commitment Therapy in Nonresponders to Cognitive Behavioral Therapy for Primary Insomnia (Hertenstein et al., 2014).”
From Acceptance and commitment group therapy among Saudi Muslim females with mental health disorders (2021) · cites this paper as Hertenstein et al., 2014
Experiential avoidance has a direct relationship with insomnia.
“Some studies also have shown direct relationships between experiential avoidance (Hertenstein et al., 2014) and cognitive fusion (Daly‐Eichenhardt et al., 2016) with insomnia.”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Hertenstein et al., 2014
ACT is efficacious in treating insomnia.
“which is efficacious in treating insomnia (Daly‐Eichenhardt et al., 2016; Hertenstein et al., 2014; Lawson et al., 2023; Rafihi‐Ferreira et al., 2024; Riemann et al., 2023; Shin et al., 2023; Zakiei & Khazaie, 2019).”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Hertenstein et al., 2014
Positive changes in cognitive fusion, experiential avoidance and sleep outcomes following ACT for insomnia have been reported.
“Positive changes in cognitive fusion (Daly‐Eichenhardt et al., 2016), experiential avoidance (Hertenstein et al., 2014) and sleep outcomes following ACT for insomnia also have been reported (Shin et al., 2023).”
From Associations between psychological inflexibility processes, pre‐sleep arousal and sleep quality. (2025) · cites this paper as Hertenstein et al., 2014
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Prise en charge de l’insomnie : cognitions
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- Authors
- Hertenstein, E., Thiel, N., Lüking, M., Külz, A. K., Schramm, E., Baglioni, C., Spiegelhalder, K., Riemann, D., & Nissen, C.
- Affiliations
- University of Freiburg (DE)
- ORCID
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 83
- Issue
- 6
- Pages
- 371-373
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W1525695601
- Cited by
- 63
- References
- 10
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 7
- FWCI
- 5.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- FAZIT Stiftung
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, cognitive behavioral therapy for insomnia, primary insomnia, treatment non-responders, quality of life
- MeSH terms
- Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Pilot Projects, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Treatment Failure, Acceptance and Commitment Therapy
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