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Erschienen in: Journal of Clinical Psychology in Medical Settings 3/2011

01.09.2011

Treating Primary Insomnia: Clinical Effectiveness and Predictors of Outcomes on Sleep, Daytime Function and Health-Related Quality of Life

verfasst von: L. Van Houdenhove, B. Buyse, L. Gabriëls, O. Van den Bergh

Erschienen in: Journal of Clinical Psychology in Medical Settings | Ausgabe 3/2011

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Abstract

Primary insomnia, as defined by DSM-IV-TR, refers to a persistent sleep disturbance which is not connected to a current psychiatric or physical condition, but significantly impairs social and occupational functioning. This study explored the impact of Cognitive Behavioral Therapy for Insomnia (CBT-i) on sleep, daytime functioning and health-related quality of life (HRQoL). Next, we investigated which factors predicted positive treatment outcome by examining demographics, insomnia characteristics, baseline levels of daytime function, HRQoL, sleep-disruptive beliefs and psychological health on post-treatment sleep quality, daytime function and HRQoL. 138 consecutive primary insomnia patients completed questionnaires pre- and post-treatment and at 6 months follow-up. After CBT-i, robust clinical improvements were observed in sleep, daytime function and HRQoL, regardless of age, gender, type or duration of the complaint. Patients with pre-treatment severe insomnia, pronounced daytime impairment and low psychological well-being benefited most.
Literatur
Zurück zum Zitat Aaronson, N. K., Muller, M., Cohen, P. D. A., Essink-Bot, M., Fekkes, M., Sanderman, R., et al. (1998). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinic Epidemiology, 1, 1055–1068.CrossRef Aaronson, N. K., Muller, M., Cohen, P. D. A., Essink-Bot, M., Fekkes, M., Sanderman, R., et al. (1998). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinic Epidemiology, 1, 1055–1068.CrossRef
Zurück zum Zitat American Academy of Sleep Medicine. (2005). International classification of sleep disorders: Diagnostic and coding manual (2nd ed.). Westchester: American Academy of Sleep Medicine. American Academy of Sleep Medicine. (2005). International classification of sleep disorders: Diagnostic and coding manual (2nd ed.). Westchester: American Academy of Sleep Medicine.
Zurück zum Zitat American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington: American Psychiatric Association. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington: American Psychiatric Association.
Zurück zum Zitat Bonnet, M., & Arand, D. L. (2010). Hyperarousal and insomnia: State of the science. Sleep Medicine Reviews, 14, 9–15.PubMedCrossRef Bonnet, M., & Arand, D. L. (2010). Hyperarousal and insomnia: State of the science. Sleep Medicine Reviews, 14, 9–15.PubMedCrossRef
Zurück zum Zitat Bültman, U., de Vries, M., Beurskens, A. J. H. M., Bleijenberg, G., & Vercoulen, J. H. M. M. (2000). Measurement of prolonged fatigue in the working population: Determination of a cut-off point for the checklist of individual strength. Journal of Occupational Health Psychology, 5, 411–416.CrossRef Bültman, U., de Vries, M., Beurskens, A. J. H. M., Bleijenberg, G., & Vercoulen, J. H. M. M. (2000). Measurement of prolonged fatigue in the working population: Determination of a cut-off point for the checklist of individual strength. Journal of Occupational Health Psychology, 5, 411–416.CrossRef
Zurück zum Zitat Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.PubMedCrossRef Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.PubMedCrossRef
Zurück zum Zitat Cohen, J. (Ed.). (1977). Statistical power analyses for the behavioral sciences. New York: Academic Press. Cohen, J. (Ed.). (1977). Statistical power analyses for the behavioral sciences. New York: Academic Press.
Zurück zum Zitat Edinger, J., Carney, C., & Wohlgemuth, W. (2008). Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. Behaviour Therapy, 39, 406–416.CrossRef Edinger, J., Carney, C., & Wohlgemuth, W. (2008). Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. Behaviour Therapy, 39, 406–416.CrossRef
Zurück zum Zitat Edinger, J., Glenn, J. M., Bastian, L., Marsh, G., Dauily, D., Hope, T. V., et al. (2003). Daytime testing after laboratory or home-based polysomnography: Comparisons of middle-aged insomnia sufferers and normal sleepers. Journal of Sleep Research, 12, 43–52.PubMedCrossRef Edinger, J., Glenn, J. M., Bastian, L., Marsh, G., Dauily, D., Hope, T. V., et al. (2003). Daytime testing after laboratory or home-based polysomnography: Comparisons of middle-aged insomnia sufferers and normal sleepers. Journal of Sleep Research, 12, 43–52.PubMedCrossRef
Zurück zum Zitat Engelen, U., De Peuter, S., Victoir, A., Van Diest, I., & Van den Bergh, O. (2006). Verdere validering van de Positive and Negative Affect Schedule (PANAS) en vergelijking van twee nederlandstalige versies. Gedrag en Gezondheid, 34, 89–102. Engelen, U., De Peuter, S., Victoir, A., Van Diest, I., & Van den Bergh, O. (2006). Verdere validering van de Positive and Negative Affect Schedule (PANAS) en vergelijking van twee nederlandstalige versies. Gedrag en Gezondheid, 34, 89–102.
Zurück zum Zitat Espie, C. A., Inglis, S. J., & Harvey, L. (2001a). Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: Analyses of outcome data at 12 months posttreatment. Journal of Consulting and Clinical Psychology, 69, 58–66.PubMedCrossRef Espie, C. A., Inglis, S. J., & Harvey, L. (2001a). Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: Analyses of outcome data at 12 months posttreatment. Journal of Consulting and Clinical Psychology, 69, 58–66.PubMedCrossRef
Zurück zum Zitat Espie, C. A., Inglis, S. J., Tessier, S., & Harvey, L. (2001b). The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: Implementation and evaluation of a sleep clinic in general medical practice. Behaviour Research and Therapy, 39, 45–60.PubMedCrossRef Espie, C. A., Inglis, S. J., Tessier, S., & Harvey, L. (2001b). The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: Implementation and evaluation of a sleep clinic in general medical practice. Behaviour Research and Therapy, 39, 45–60.PubMedCrossRef
Zurück zum Zitat Goldberg, D. P. (Ed.). (1972). The detection of psychiatric illness by questionnaire. London: Oxford University Press. Goldberg, D. P. (Ed.). (1972). The detection of psychiatric illness by questionnaire. London: Oxford University Press.
Zurück zum Zitat Horne, J. (2010). Primary Insomnia: A disorder of sleep, or primarily one of wakefulness? Sleep Medicine Reviews, 14, 3–7.PubMedCrossRef Horne, J. (2010). Primary Insomnia: A disorder of sleep, or primarily one of wakefulness? Sleep Medicine Reviews, 14, 3–7.PubMedCrossRef
Zurück zum Zitat Jansson-Fröjmark, M., & Linton, S. (2008). The role of sleep-related beliefs to improvement in early cognitive behavioral therapy for insomnia. Cognitive Behaviour Therapy, 37, 5–13.PubMedCrossRef Jansson-Fröjmark, M., & Linton, S. (2008). The role of sleep-related beliefs to improvement in early cognitive behavioral therapy for insomnia. Cognitive Behaviour Therapy, 37, 5–13.PubMedCrossRef
Zurück zum Zitat Koeter, M. W. J., & Ormel, J. (Eds). (1991). General Health Questionnaire. Lisse Swets Test Services. Koeter, M. W. J., & Ormel, J. (Eds). (1991). General Health Questionnaire. Lisse Swets Test Services.
Zurück zum Zitat Kyle, S. D., & Espie, C. A. (2010). “…Not just a minor thing, it is something major, which stops you from functioning daily”: Quality of life and daytime functioning in insomnia. Behavioral Sleep Medicine, 8, 123–140.PubMedCrossRef Kyle, S. D., & Espie, C. A. (2010). “…Not just a minor thing, it is something major, which stops you from functioning daily”: Quality of life and daytime functioning in insomnia. Behavioral Sleep Medicine, 8, 123–140.PubMedCrossRef
Zurück zum Zitat Kyle, S. D., Morgan, K., & Espie, C. A. (2009). Insomnia and health-related quality of life. Sleep Medicine Reviews, 14, 69–82.PubMedCrossRef Kyle, S. D., Morgan, K., & Espie, C. A. (2009). Insomnia and health-related quality of life. Sleep Medicine Reviews, 14, 69–82.PubMedCrossRef
Zurück zum Zitat Léger, D., Scheuermaier, K., Philip, P., Paillard, M., & Guilleminault, C. (2001). SF-36: Evaluation of Quality of Life in severe and mild insomniacs compared with good sleepers. Psychosomatic Medicine, 63, 49–55.PubMed Léger, D., Scheuermaier, K., Philip, P., Paillard, M., & Guilleminault, C. (2001). SF-36: Evaluation of Quality of Life in severe and mild insomniacs compared with good sleepers. Psychosomatic Medicine, 63, 49–55.PubMed
Zurück zum Zitat Marks, R., Allegrante, J. P., & Lorig, K. (2005). A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: Implications for health education (Part 2). Health Promotion Practice, 6, 148–156.PubMedCrossRef Marks, R., Allegrante, J. P., & Lorig, K. (2005). A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: Implications for health education (Part 2). Health Promotion Practice, 6, 148–156.PubMedCrossRef
Zurück zum Zitat Montazeri, A., Harirchi, A., Shariati, M., Garmaroudi, G., Ebadi, E. & Fateh, A. (2003). The 12-item General Health Questionnaire (GHQ-12): Translation and validation study of the Iranian version. Health and Quality of Life Outcomes, 1, 66.PubMedCrossRef Montazeri, A., Harirchi, A., Shariati, M., Garmaroudi, G., Ebadi, E. & Fateh, A. (2003). The 12-item General Health Questionnaire (GHQ-12): Translation and validation study of the Iranian version. Health and Quality of Life Outcomes, 1, 66.PubMedCrossRef
Zurück zum Zitat Morin, C. M. (1993). Insomnia: Psychological assessment and management. New York: Guilford Press. Morin, C. M. (1993). Insomnia: Psychological assessment and management. New York: Guilford Press.
Zurück zum Zitat Morin, C. M., Bootzin, R. R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998–2004). Sleep, 29, 1398–1414.PubMed Morin, C. M., Bootzin, R. R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998–2004). Sleep, 29, 1398–1414.PubMed
Zurück zum Zitat Morin, C. M., Culbert, J. P., & Schwartz, S. M. (1994). Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry, 151, 1172–1180.PubMed Morin, C. M., Culbert, J. P., & Schwartz, S. M. (1994). Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry, 151, 1172–1180.PubMed
Zurück zum Zitat Morin, C. M., & Espie, C. A. (2004). Insomnia: A clinical guide to assessment and treatment. New York: Springer. Morin, C. M., & Espie, C. A. (2004). Insomnia: A clinical guide to assessment and treatment. New York: Springer.
Zurück zum Zitat Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999). Nonpharmacologic treatment of chronic insomnia: An American Academy of Sleep Medicine review. Sleep, 22, 1–25. Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999). Nonpharmacologic treatment of chronic insomnia: An American Academy of Sleep Medicine review. Sleep, 22, 1–25.
Zurück zum Zitat Morin, C. M., Vallières, A., & Ivers, H. (2007). Dysfunctional Beliefs and Attitudes about Sleep (DBAS): Validation of a brief version (DBAS-16). Sleep, 30, 1547–1554.PubMed Morin, C. M., Vallières, A., & Ivers, H. (2007). Dysfunctional Beliefs and Attitudes about Sleep (DBAS): Validation of a brief version (DBAS-16). Sleep, 30, 1547–1554.PubMed
Zurück zum Zitat Murtagh, D. R., & Greenwood, K. M. (1995). Identifying effective psychological treatments for insomnia: A meta-analysis. Journal of Consulting and Clinical Psychology, 63, 79–89.PubMedCrossRef Murtagh, D. R., & Greenwood, K. M. (1995). Identifying effective psychological treatments for insomnia: A meta-analysis. Journal of Consulting and Clinical Psychology, 63, 79–89.PubMedCrossRef
Zurück zum Zitat National Institutes of Health. (2005). National Institutes of Health State of the Science Conference Statement. Sleep, 28, 1049–1057. National Institutes of Health. (2005). National Institutes of Health State of the Science Conference Statement. Sleep, 28, 1049–1057.
Zurück zum Zitat Omvik, S., Sivertsen, B., Pallesen, S., Bjorvatn, B., Havik, O. E., & Nordhus, I. H. (2008). Daytime functioning in older patients suffering from chronic insomnia: Treatment outcome in a randomized controlled trial comparing CBT with Zopiclone. Behaviour Research and Therapy, 46, 623–641.PubMedCrossRef Omvik, S., Sivertsen, B., Pallesen, S., Bjorvatn, B., Havik, O. E., & Nordhus, I. H. (2008). Daytime functioning in older patients suffering from chronic insomnia: Treatment outcome in a randomized controlled trial comparing CBT with Zopiclone. Behaviour Research and Therapy, 46, 623–641.PubMedCrossRef
Zurück zum Zitat Perlis, M., Aloia, M., Millikan, A., Boehmler, J., Smith, M., Greenblatt, D., et al. (2000). Behavioral treatment of insomnia: A clinical case series study. Journal of Behavioral Medicine, 23, 149–161.PubMedCrossRef Perlis, M., Aloia, M., Millikan, A., Boehmler, J., Smith, M., Greenblatt, D., et al. (2000). Behavioral treatment of insomnia: A clinical case series study. Journal of Behavioral Medicine, 23, 149–161.PubMedCrossRef
Zurück zum Zitat Riedel, B., Lichstein, K., Peterson, B. A., Epperson, M. T., Means, M. K., & Aguillard, R. N. (1998). A comparison of the efficacy of stimulus control for medicated and non medicated insomniacs. Behavioral Modification, 22, 3–28.CrossRef Riedel, B., Lichstein, K., Peterson, B. A., Epperson, M. T., Means, M. K., & Aguillard, R. N. (1998). A comparison of the efficacy of stimulus control for medicated and non medicated insomniacs. Behavioral Modification, 22, 3–28.CrossRef
Zurück zum Zitat Riemann, D., & Perlis, M. L. (2009). The treatments of chronic insomnia: A review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Medicine Reviews, 13, 205–214.PubMedCrossRef Riemann, D., & Perlis, M. L. (2009). The treatments of chronic insomnia: A review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Medicine Reviews, 13, 205–214.PubMedCrossRef
Zurück zum Zitat Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., et al. (2010). The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews, 14, 19–31.PubMedCrossRef Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., et al. (2010). The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews, 14, 19–31.PubMedCrossRef
Zurück zum Zitat Sillis, H., & Cluydts, R. (1992). Een nederlandstalige bewerking van de Pittsburghse slaapkwaliteitsindex (PSQI). Unpublished. Sillis, H., & Cluydts, R. (1992). Een nederlandstalige bewerking van de Pittsburghse slaapkwaliteitsindex (PSQI). Unpublished.
Zurück zum Zitat Spielman, A., Caruso, L., & Glovinsky, P. (1987). A behavioral perspective on insomnia treatment. Psychiatry Clinics of NorthAmerica, 10, 541–553. Spielman, A., Caruso, L., & Glovinsky, P. (1987). A behavioral perspective on insomnia treatment. Psychiatry Clinics of NorthAmerica, 10, 541–553.
Zurück zum Zitat Strecher, V. J., DeVellis, B. M., & Rosenstock, I. M. (1986). The role of self-efficacy in achieving health behavior change. Health Education Quarterly, 13, 73–91.PubMed Strecher, V. J., DeVellis, B. M., & Rosenstock, I. M. (1986). The role of self-efficacy in achieving health behavior change. Health Education Quarterly, 13, 73–91.PubMed
Zurück zum Zitat Van der Lee, M. L. & Garssen, B. (2010). Mindfulness-based cognitive therapy reduces chronic cancer-related fatigue: A treatment study. Psycho-oncology, published online. Van der Lee, M. L. & Garssen, B. (2010). Mindfulness-based cognitive therapy reduces chronic cancer-related fatigue: A treatment study. Psycho-oncology, published online.
Zurück zum Zitat Verbeke, G., & Molenberghs, G. (1997). Linear mixed models in practice: A SAS-oriented approach. In Lecture Notes in Statistics. New York: Springer. Verbeke, G., & Molenberghs, G. (1997). Linear mixed models in practice: A SAS-oriented approach. In Lecture Notes in Statistics. New York: Springer.
Zurück zum Zitat Vercoulen, J. H. M. M., Swanink, C. M. A., Fennis, J. F. M., Galama, J. M. D., Van der Meer, J. W. M., & Bleijenberg, G. (1994). Dimensional assessment of chronic fatigue syndrome. Journal of Psychosomatic Research, 38, 383–392.PubMedCrossRef Vercoulen, J. H. M. M., Swanink, C. M. A., Fennis, J. F. M., Galama, J. M. D., Van der Meer, J. W. M., & Bleijenberg, G. (1994). Dimensional assessment of chronic fatigue syndrome. Journal of Psychosomatic Research, 38, 383–392.PubMedCrossRef
Zurück zum Zitat Vincent, N. K., & Hameed, H. (2003). Relation between adherence and outcome in the group treatment of insomnia. Behavioral Sleep Medicine, 1, 125–139.PubMedCrossRef Vincent, N. K., & Hameed, H. (2003). Relation between adherence and outcome in the group treatment of insomnia. Behavioral Sleep Medicine, 1, 125–139.PubMedCrossRef
Zurück zum Zitat Ware, J. R., & Sherbourn, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.PubMedCrossRef Ware, J. R., & Sherbourn, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.PubMedCrossRef
Zurück zum Zitat Watson, D., Clark, L. A., & Tellegen, A. (1998). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.CrossRef Watson, D., Clark, L. A., & Tellegen, A. (1998). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.CrossRef
Zurück zum Zitat Westbrook, D., & Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: Outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43, 124312–124361.CrossRef Westbrook, D., & Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: Outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43, 124312–124361.CrossRef
Metadaten
Titel
Treating Primary Insomnia: Clinical Effectiveness and Predictors of Outcomes on Sleep, Daytime Function and Health-Related Quality of Life
verfasst von
L. Van Houdenhove
B. Buyse
L. Gabriëls
O. Van den Bergh
Publikationsdatum
01.09.2011
Verlag
Springer US
Erschienen in
Journal of Clinical Psychology in Medical Settings / Ausgabe 3/2011
Print ISSN: 1068-9583
Elektronische ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-011-9250-7

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