Improvement of Insomnia Symptoms following a Single 4-Hour CBT-I Workshop

ABSTRACT

Study Objectives

: Cognitive behavioral treatment for insomnia (CBT-I) is the first line of treatment for insomnia. However, the expanded use of CBT-I is limited by the number of specialty-trained clinicians in addition to the duration and cost of individual treatment sessions. One viable option is a single-session educational group format delivered by a trained health educator.

Methods

: In a preliminary, single group pretest-posttest design, the effectiveness of group CBT-I delivered to community dwelling individuals with self-reported insomnia symptoms was evaluated. Participants completed the Insomnia Severity Index (ISI) and provided information on sleep aid use, prior to and 1-month post attendance of a single 4-hour CBT-I workshop.

Results

: Participants (N = 45) were 54 ± 16 years and 71% female. ISI scores significantly improved from baseline (20.09 ± 4.1) to 1-month follow-up (11.89 ±5.7; t = 10.1, p < .001) with an average change of 8.2 ± 5.4 points. Frequency of sleep aid use significantly dropped (χ² = 105.7, p = .017). Eighty percent of participants reported sleeping better or much better at follow-up. Twenty percent of participants met criteria for remission of insomnia and 35.6% of participants had ISI change scores meeting criteria for a Minimally Important Difference associated with improvements in fatigue, work productivity, and health related quality of life.

Conclusions

: These preliminary data suggest that a single 4-hour CBT-I workshop delivered by a health educator can significantly improve insomnia symptoms, improve subjective sleep quality, and reduce sleep aid use among community dwelling adults with and without co-morbidities within 1-month.

Brief Summary

1. Current knowledge/study rationale: In order to disseminate CBT-I to a broader section of the population with insomnia complaints, novel approaches need to be incorporated and assessed. The utilization of a single 4-hour group CBT-I session may be a suitable choice for many people experiencing insomnia.

2. Study Impact: In comparison to the 4-8 individual sessions commonly available, this format shows promise as another option for treatment of insomnia, and preliminarily shows comparable effectiveness for various sleep outcomes. Moreover, by utilizing a non-clinician health educator to provide these workshops, the number of people that may be helped with CBT-I is increased.

Abbreviations: CBT-I: Cognitive Behavioral Treatment for InsomniaCGI: clinical global improvementISI: Insomnia Severity IndexISR: Intensive sleep retrainingMID: Minimally important differenceOTC: Over the counterROC: Receiver operator curveSCID-DSM-V: Structured Clinical Interview for the Diagnostic Statistical Manual-V

Acknowledgments

The authors would like to thank the participants of the study.

All authors have seen, contributed, and approved the manuscript.

Disclosure statement

Financial Disclosure: None of the participants paid for the workshop. They were offered it at no charge for their participation.

Non-Financial Disclosure: Dr. Okun and Dr. Glidewell are employed by the Insomnia Clinic

Data availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.