Introduction
CBT-I in Psychiatric Disorders
Anxiety Disorders
Depression
Authors (year) | Sample description | Study design | Interventions: format, frequency and duration | CBT-I components |
---|---|---|---|---|
Ashworth et al. (2015) [27••] | 41 participants with major depression and insomnia | RCT (1) Individual CBT-I (2) Self-help CBT-I | Individual interventions, 4 sessions of CBT-I or self-help CBT-I over 8 weeks | Psychoeducation, sleep hygiene, abdominal breathing, stimulus control, sleep restriction, progressive muscle relaxation, cognitive restructuring, imagery relaxation, self-management, relapse prevention and mindfulness |
Blom et al. (2015) [28••] | 43 participants with major depression and insomnia | RCT (1) CBT-I (2) CBT-D | Internet-based interventions with therapist support, 9 modules over 9 weeks | Psychoeducation, sleep hygiene, education on sleep medication and how to quit, sleep restriction, stimulus control, stress management, managing fatigue, handling negative thoughts about sleep and planning ahead |
Clarke et al. (2015) [30••] | 41 participants with major depression and insomnia | RCT (1) CBT-I + CBT-D (2) Sleep hygiene + CBT-D | Individual interventions, 3–4 sessions of CBT-I or SH + 4–6 sessions of CBT-D over 12 weeks | Stimulus control, sleep restriction, cognitive techniques to alter unhelpful beliefs regarding insomnia, regularising day/night schedules and savouring |
Freeman et al. (2015) [31••] | 50 patients with a psychotic disorder with persistent, distressing delusions or hallucinations and insomnia | RCT (1) Standard care plus CBT-I (2) Standard care | Individual interventions, 8 sessions over 12 weeks | Psychoeducation, assessment, goal setting; the following components were delivered optionally, based on the assessment: stimulus control, establishment of appropriate daytime activity and circadian rhythms, sleep hygiene, relaxation training, cognitive techniques and relapse prevention |
Gellis et al. [2011] [32] | 8 patients with post-traumatic stress disorder and insomnia | Open trial (1) CBT-I | Individual intervention, 5 sessions over 5 weeks | Stimulus control, sleep hygiene, sleep compression and relaxation training |
Harvey et al. (2015) [33••] | 58 participants with bipolar I and insomnia | RCT (1) CBT-I-BP (2) Psychoeducation | Individual interventions, 8 sessions over 8 weeks | Psychoeducation, case formulation, motivational interviewing, goal setting, stimulus control, sleep restriction, devising wind-down routines in dim light and wake up routines in bright light, cognitive techniques to alter unhelpful beliefs, anxiety, vigilance, worry and rumination, behavioural experiments, and relapse prevention |
Myers et al. (2011) [34] | 15 patients with a psychotic disorder with persistent persecutory delusions and insomnia | Open trial (1) CBT-I | Individual intervention, 4 weekly or biweekly sessions over 4–8 weeks | Psychoeducation, assessment, goal setting; the following components were delivered optionally (based on the assessment): stimulus control, establishment of appropriate daytime activity and circadian rhythms, sleep hygiene, relaxation training, cognitive techniques and relapse prevention |
Norell-Clarke et al. (2015) [29••] | 64 participants with major depression or subthreshold depression and insomnia | RCT (1) CBT-I (2) Relaxation training | Group interventions, 4 sessions over 7 weeks | Psychoeducation, sleep hygiene, sleep restriction, stimulus control, cognitive techniques (constructive worry, thought records and cognitive restructuring) and relapse prevention |
Talbot et al. (2014) [35••] | 45 patients with post-traumatic stress disorder and insomnia | RCT (1) CBT-I (2) Monitor-only waitlist control | Individual interventions, 8 sessions over 8 weeks | Stimulus control, sleep restriction, sleep hygiene, cognitive intervention to address catastrophic beliefs and relapse prevention |