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Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial

Published online by Cambridge University Press:  16 December 2015

J. Cape ,
J. Leibowitz ,
C. Whittington ,
C. A. Espie  and
S. Pilling
J. Cape*
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK Camden and Islington NHS Foundation Trust, London, UK
J. Leibowitz
Affiliation:
Camden and Islington NHS Foundation Trust, London, UK
C. Whittington
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
C. A. Espie
Affiliation:
Nuffield Department of Clinical Neurosciences/ Sleep & Circadian Neuroscience Institute, University of Oxford, Oxford, UK
S. Pilling
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK Camden and Islington NHS Foundation Trust, London, UK
*
*Address for correspondence: Dr J. Cape, Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK. (Email: j.cape@ucl.ac.uk)
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Abstract

Background

Insomnia disorder is common and often co-morbid with mental health conditions. Cognitive behavioural therapy (CBT) for insomnia is effective, but is rarely implemented as a discrete treatment. The aim of this study was to evaluate the effectiveness of brief CBT groups for insomnia compared to treatment as usual (TAU) for insomnia delivered by mental health practitioners in a primary-care mental health service.

Method

A total of 239 participants were randomized to either a five-session CBT group or to TAU. Assessments of sleep and of symptoms of depression and anxiety were carried out at baseline, post-treatment and at 20 weeks. Primary outcome was sleep efficiency post-treatment.

Results

Group CBT participants had better sleep outcomes post-treatment than those receiving TAU [sleep efficiency standardized mean difference 0.63, 95% confidence interval (CI) 0.34–0.92]. The effect at 20 weeks was smaller with a wide confidence interval (0.27, 95% CI −0.03 to 0.56). There were no important differences between groups at either follow-up period in symptoms of anxiety or depression.

Conclusions

Dedicated CBT group treatment for insomnia improves sleep more than treating sleep as an adjunct to other mental health treatment.

Keywords

Cognitive behavioural therapiesoutcome studiesprimary carerandomized controlled trialsleep disorders
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 5 , April 2016 , pp. 1015 - 1025
Copyright
Copyright © Cambridge University Press 2015 

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