The Role of Sleep‐Related Beliefs to Improvement in Early Cognitive Behavioral Therapy for Insomnia

Abstract

The aim of this investigation was to examine whether sleep‐related beliefs, and reductions in such beliefs and attitudes, were related to clinical improvements in sleep and daytime symptoms after cognitive behavioral therapy (CBT). In total, 64 patients with a short history of insomnia (3–12 months) who had participated in a randomized controlled trial with a 1‐year follow‐up and received CBT were included. With stepwise multiple regression analyses, sleep‐related beliefs were linked to clinical improvements in sleep (five outcomes) and daytime symptoms (seven outcomes). Results indicated that sleep‐related beliefs played a small predictive role in clinical improvements in sleep and daytime symptoms after CBT group treatment. Sleep‐related beliefs were predictive of treatment response only with regard to sleep efficiency and sleepiness. Reductions in sleep‐related beliefs were, however, differently related to improvements in sleep and daytime symptoms. Reductions in such beliefs were consistently linked to improvements in daytime symptoms (7–14% of the variance) but not to sleep improvements (except for sleep quality). In all, this might suggest that sleep‐related beliefs play a slightly different role in insomnia than previously envisioned.

Keywords:

• insomnia
• cognitive behavioral therapy
• sleep‐related beliefs
• clinical improvement

Acknowledgments

We express our appreciation to AFA Sweden for financial support and to the participants in this project.