J Clin Outcomes Manage
Cognitive behavioral therapy for insomnia
Cribbet MR, Pigeon WR
Abstract Objective: To review treatment principles of cognitive behavioral therapy for insomnia (CBT-I). Method: Review of the literature and case presentation. Results: Insomnia complaints are common, rise to a clinically significant level among approximately 10% of the population, and seldom remit without direct intervention. CBT-I has demonstrated efficacy as an intervention for insomnia and its effects are comparable, and in some cases superior, to those of medication. Treatment effects for CBT-I are maintained following discontinuation of provider contact and are also observed when CBT-I is delivered to patients with a variety of psychiatric and medical conditions that commonly present with insomnia. CBT-I is a multicomponent therapy typically delivered over 6 to 8 weeks that includes both behavioral strategies and cognitive interventions aimed at addressing the key etiological factors of insomnia (eg, hyperarousal, circadian dysregulation, and a disrupted homeostatic drive coupled with maladaptive behaviors and dysfunctional cognitions about sleep). A discussion of how a sleep-focused assessment informs a cognitive-behavioral case conceptualization is followed by a case-based illustration of the core treatment components of CBT-I. Conclusion: CBT-I is an empirically supported treatment for insomnia. Future efforts should focus on dissemination of this evidence-based therapy
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