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Telephone-Delivered Cognitive Behavioral Therapy Helps with Insomnia

09 Jun

In a randomized, controlled parallel trial, researchers from the Sleep and Chronophysiology Laboratory at the University of Michigan assessed the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia.
 
The thirty subjects had chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years).

In the experimental condition, cognitive behavioral therapy for insomnia (CBTI) was delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus a control condition that consisted of an information pamphlet (IPC, n = 15).
 
Measurements consisted of a sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life).

These measures were taken at pre-treatment, post-treatment, and 12-wk follow-up.
 
Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups, and remained stable at 12-wk follow-up.
 
More CBTI-Phone than IPC patients showed post-treatment improvements in unhelpful sleep-related cognitions (P < 0.001) and were classified as "in remission" from insomnia at follow-up (P < 0.05).
 
Post-treatment effect sizes on most daytime symptoms were large (Cohen d = 0.8-2.5) for CBTI-Phone patients and small to moderate (Cohen d = -0.1-0.6) for IPC patients.
 
All CBTI-Phone patients completed post-treatment and 12-wk follow-up assessments, but three IPC patients discontinued the study.

Investigators conclude that these findings provide preliminary support for telephone-delivered CBTI in the treatment of chronic insomnia. Additionally, some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support.  Future larger-scale studies with more diverse samples are warranted.

Citation: Arnedt JT1, Cuddihy L, Swanson LM, Pickett S, Aikens J, Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. Sleep. 2013 Mar 1;36(3):353-62. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award