Research Article
Effectiveness of a CBT Intervention for Persistent Insomnia and Hypnotic Dependency in an Outpatient Psychiatry Clinic
Hannah Lund Taylor,
Bruce D. Rybarczyk, William Nay, David Leszczyszyn,
Corresponding Author
Hannah Lund Taylor
Rush University Medical Center
Please address correspondence to: Hannah Lund Taylor, Rush University Medical Center, Johnston R. Bowman Health Center, 710 S. Paulina Street, Suite 600, Chicago, IL 60612.Search for more papers by this authorHannah Lund Taylor,
Bruce D. Rybarczyk, William Nay, David Leszczyszyn,
Corresponding Author
Hannah Lund Taylor
Rush University Medical Center
Please address correspondence to: Hannah Lund Taylor, Rush University Medical Center, Johnston R. Bowman Health Center, 710 S. Paulina Street, Suite 600, Chicago, IL 60612.Search for more papers by this authorThis research was completed at the Virginia Commonwealth University Medical Center.
Abstract
Objective
To test cognitive-behavioral therapy for insomnia (CBT-I) in patients who not only receive psychiatric treatment in a outpatient psychiatry clinic but also continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. CBT-I included an optional module for discontinuing hypnotic medications.
Method
Patients were randomized to 5 sessions of individual CBT-I (n = 13) or treatment as usual (n = 10). Sleep parameters were assessed using sleep diaries at pre- and posttreatment. Questionnaires measuring depression, anxiety, and health-related quality of life were also administered.
Results
CBT-I was associated with significant improvement in sleep, with 46% obtaining normal global sleep ratings after treatment. However, no changes in secondary outcomes (depression, anxiety, quality of life) were obtained and no patients elected to discontinue their hypnotic medications.
Conclusions
Patients with complex, chronic psychiatric conditions can obtain sleep improvements with CBT-I beyond those obtained with pharmacotherapy alone; however, sleep interventions alone may not have the same effect on mental health outcomes in samples with more severe and chronic psychiatric symptoms and dependency on hypnotic medications.
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