Abstract
Introduction
Although more than half of primary care patients endorse insomnia symptoms, few options are available to manage their sleep continuity disturbance. CBT-I is the first line treatment for insomnia, but a standard course of at least 6 sessions is typically not feasible in primary care settings. The present RCT investigated a “single shot” version of CBT-I in primary care patients suffering from clinically elevated insomnia symptoms.
Methods
Forty-one primary care patients (Mage = 26.2, SDage = 9.4; 70.7% women, 73.2% White) at an integrated behavioral health center were enrolled in the current study and randomly assigned to either one session of CBT-I or one session of an attentional control condition. Daily sleep diaries were used to assess changes in total wake time (TWT = SL+WASO+EMA) and sleep efficiency (%SE) at (1) baseline, (2) one-week post-treatment, and (3) one-month post-treatment. Insomnia symptoms (ISI) and depression symptoms (PHQ-8) were also assessed at baseline and one-month post-treatment.
Results
The final analyses included data from 37 patients (CBT-I = 17, control = 20), after 4 patients were lost to follow-up. Compared to the control group, patients who received one-session of CBT-I reported greater improvements in TWT (t(33) = -2.54, p<.01; mean difference = -42.64; Cohen’s d = -0.86) and %SE (t(33) = 1.80, p<.05; mean difference = 0.05; Cohen’s d=0.61) from baseline to post-treatment. The CBT-I patients continued to show greater improvements through the 1-month follow-up in TWT (t(30) = -4.11, p <.001; mean difference = -73.28; Cohen’s d = -1.46) and %SE (t(30) = 3.18, p<.01; mean difference = 0.12; Cohen’s d = 1.13). There was also greater improvement for patients in the CBT-I group on ISI scores (t(30) = -1.85, p<.05; mean difference = -2.65; Cohen’s d = -0.66) and PHQ-8 scores (t(29) = -2.29, p<.05; mean difference = -3.70; Cohen’s d = -0.83) from baseline to 1 month follow-up.
Conclusion
The present study provides preliminary data to support the use of “single-shot” CBT-I in primary care settings. Furthermore, results suggest that this one-session version of CBT-I may provide a potential benefit beyond sleep by also having meaningful effects on depression symptoms. Support (if any) K23-HL141581
Although more than half of primary care patients endorse insomnia symptoms, few options are available to manage their sleep continuity disturbance. CBT-I is the first line treatment for insomnia, but a standard course of at least 6 sessions is typically not feasible in primary care settings. The present RCT investigated a “single shot” version of CBT-I in primary care patients suffering from clinically elevated insomnia symptoms.
Methods
Forty-one primary care patients (Mage = 26.2, SDage = 9.4; 70.7% women, 73.2% White) at an integrated behavioral health center were enrolled in the current study and randomly assigned to either one session of CBT-I or one session of an attentional control condition. Daily sleep diaries were used to assess changes in total wake time (TWT = SL+WASO+EMA) and sleep efficiency (%SE) at (1) baseline, (2) one-week post-treatment, and (3) one-month post-treatment. Insomnia symptoms (ISI) and depression symptoms (PHQ-8) were also assessed at baseline and one-month post-treatment.
Results
The final analyses included data from 37 patients (CBT-I = 17, control = 20), after 4 patients were lost to follow-up. Compared to the control group, patients who received one-session of CBT-I reported greater improvements in TWT (t(33) = -2.54, p<.01; mean difference = -42.64; Cohen’s d = -0.86) and %SE (t(33) = 1.80, p<.05; mean difference = 0.05; Cohen’s d=0.61) from baseline to post-treatment. The CBT-I patients continued to show greater improvements through the 1-month follow-up in TWT (t(30) = -4.11, p <.001; mean difference = -73.28; Cohen’s d = -1.46) and %SE (t(30) = 3.18, p<.01; mean difference = 0.12; Cohen’s d = 1.13). There was also greater improvement for patients in the CBT-I group on ISI scores (t(30) = -1.85, p<.05; mean difference = -2.65; Cohen’s d = -0.66) and PHQ-8 scores (t(29) = -2.29, p<.05; mean difference = -3.70; Cohen’s d = -0.83) from baseline to 1 month follow-up.
Conclusion
The present study provides preliminary data to support the use of “single-shot” CBT-I in primary care settings. Furthermore, results suggest that this one-session version of CBT-I may provide a potential benefit beyond sleep by also having meaningful effects on depression symptoms. Support (if any) K23-HL141581
| Original language | English |
|---|---|
| Pages (from-to) | A234-A234 |
| Number of pages | 1 |
| Journal | Sleep |
| Volume | 48 |
| Issue number | Supplement_1 |
| DOIs | |
| Publication status | Published - 19 May 2025 |