Residual sleep beliefs and sleep disturbance following Cognitive Behavioral Therapy for major depression

2011 ◽  
Vol 28 (6) ◽  
pp. 464-470 ◽  
Author(s):  
Colleen E. Carney ◽  
Andrea L. Harris ◽  
Joey Friedman ◽  
Zindel V. Segal
Keyword(s):  
Major Depression ◽  
Cognitive Behavioral Therapy ◽  
Sleep Disturbance ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

scholarly journals The Chicken and/or the Egg?

2019 ◽  
pp. 555-570
Author(s):  
Ketan Deoras ◽  
Jonathan Oliver ◽  
Mita S. Deoras
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Sleep Disturbance ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Comorbid Insomnia ◽  
Time Treatment ◽  
Bidirectional Relationship ◽  
Prevalence Of Depression ◽  
Sedative Hypnotics

This chapter covers the bidirectional relationship between depression and insomnia. Patients with insomnia are more likely to develop depression; the prevalence of depression in people with comorbid insomnia is almost 10 times greater than in those without insomnia. Conversely, depression itself has sleep disturbance as a symptom 80% of the time. Treatment of comorbid insomnia and depression should aim at treating both conditions. While cognitive-behavioral therapy for insomnia (CBT-i) should always be considered in the treatment of chronic insomnia, instances may arise when medications are required. Sedative–hypnotics derive from a wide variety of classes of medications and may need to be used in conjunction with antidepressants in the depressed insomniac.

scholarly journals Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Victoria Ka-Ying Hui ◽  
Christy Yim-Fan Wong ◽  
Eric Ka-Yiu Ma ◽  
Fiona Yan-Yee Ho ◽  
Christian S. Chan
Keyword(s):  
Randomized Controlled Trial ◽  
Hong Kong ◽  
Major Depression ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Cognitive Behavioral ◽  
Randomized Controlled ◽  
Self Help

Abstract Background Depression is a major public health concern. Emerging research has shown that cognitive behavioral therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper reports a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, using a waitlist group as control, for people with major depression and insomnia. Methods A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow-up. The recruitment is completed. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I intervention. Discussion It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, thereby reducing the burden of the public healthcare system in Hong Kong. Trial registration ClinicalTrials.gov NCT04228146. Retrospectively registered on 14 January 2020.

scholarly journals Polysomnographic Predictors of Treatment Response to Cognitive Behavioral Therapy for Insomnia in Participants With Co-morbid Insomnia and Sleep Apnea: Secondary Analysis of a Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander Sweetman ◽  
Bastien Lechat ◽  
Peter G. Catcheside ◽  
Simon Smith ◽  
Nick A. Antic ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sleep Apnea ◽  
Cognitive Behavioral Therapy ◽  
Sleep Disturbance ◽  
Treatment Response ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Randomized Controlled ◽  
Pre Treatment

ObjectiveCo-morbid insomnia and sleep apnea (COMISA) is a common and debilitating condition that is more difficult to treat compared to insomnia or sleep apnea-alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia (CBTi) is effective in patients with COMISA, however, those with more severe sleep apnea and evidence of greater objective sleep disturbance may be less responsive to CBTi. Polysomnographic sleep study data has been used to predict treatment response to CBTi in patients with insomnia-alone, but not in patients with COMISA. We used randomized controlled trial data to investigate polysomnographic predictors of insomnia improvement following CBTi, versus control in participants with COMISA.MethodsOne hundred and forty five participants with insomnia (ICSD-3) and sleep apnea [apnea-hypopnea index (AHI) ≥ 15] were randomized to CBTi (n = 72) or no-treatment control (n = 73). Mixed models were used to investigate the effect of pre-treatment AHI, sleep duration, and other traditional (AASM sleep macrostructure), and novel [quantitative electroencephalography (qEEG)] polysomnographic predictors of between-group changes in Insomnia Severity Index (ISI) scores from pre-treatment to post-treatment.ResultsCompared to control, CBTi was associated with greater ISI improvement among participants with; higher AHI (interaction p = 0.011), less wake after sleep onset (interaction p = 0.045), and less N3 sleep (interaction p = 0.005). No quantitative electroencephalographic, or other traditional polysomnographic variables predicted between-group ISI change (all p > 0.09).DiscussionAmong participants with COMISA, higher OSA severity predicted a greater treatment-response to CBTi, versus control. People with COMISA should be treated with CBTi, which is effective even in the presence of severe OSA and objective sleep disturbance.

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