CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial
Year: 2019
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Subjective and objective estimates of sleep are often discordant among individuals with insomnia who typically under-report sleep time and over-report wake time at night. This study examined the impact and durability of cognitive-behavioural therapy for insomnia on improving the accuracy of sleep and wake perceptions in older adults, and tested whether changes in sleep quality were related to changes in the accuracy of sleep/wake perceptions. One-hundred and fifty-nine older veterans (97% male, mean age 72.2 years) who met diagnostic criteria for insomnia disorder were randomized to: (1) cognitive-behavioural therapy for insomnia (n = 106); or (2) attention control (n = 53). Assessments were conducted at baseline, post-treatment, 6-months and 12-months follow-up. Sleep measures included objective (via wrist actigraphy) and subjective (via self-report diary) total sleep time and total wake time, along with Pittsburgh Sleep Quality Index score. Discrepancy was computed as the difference between objective and subjective estimates of wake and sleep. Minutes of discrepancy were compared between groups across time, as were the relationships between Pittsburgh Sleep Quality Index scores and subsequent changes in discrepancy. Compared with controls, participants randomized to cognitive-behavioural therapy for insomnia became more accurate (i.e. minutes discrepancy was reduced) in their perceptions of sleep/wake at post-treatment, 6-months and 12-months follow-up (p < .05). Improved Pittsburgh Sleep Quality Index scores at each study assessment preceded and predicted reduced discrepancy at the next study assessment (p < .05). Cognitive-behavioural therapy for insomnia reduces sleep/wake discrepancy among older adults with insomnia. The reductions may be driven by improvements in sleep quality. Improving sleep quality appears to be a viable path to improving sleep perception and may contribute to the underlying effectiveness of cognitive-behavioural therapy for insomnia.
Source: Journal of Sleep Research
DOI: 10.1111/jsr.12809
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funders: John A. Hartford Foundation, American Federation for Aging Research, Hartford Foundation for Public Giving, Atlantic Philanthropies, Health Services Research and Development, National Institutes of Health, University of California, Los Angeles, National Institute on Aging, National Heart, Lung, and Blood Institute, National Center for Advancing Translational Sciences
Awards: G1893322342, G2356803359, UCLA Clinical and Translational Science Institute, Cognitive and inflammatory consequences of sleep disorders in older adults, A Dyadic Sleep Intervention for Alzheimers Disease Patients and Their Caregivers, G5666620221, G6921748730, G7575723049, UCLA Older Americans Independence Center, G835508293
OpenAlex ID: W2907330077