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VOLUME 36, ISSUE 03

RANDOMIZED CONTROLLED TRIAL OF TELEPHONE-DELIVERED CBT FOR INSOMNIA
Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

http://dx.doi.org/10.5665/sleep.2448

J. Todd Arnedt, PhD1,3; Leisha Cuddihy, PhD1; Leslie M. Swanson, PhD1; Scott Pickett, PhD4; James Aikens, PhD2; Ronald D. Chervin, MD, MS3

1Sleep and Chronophysiology Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI; 2Department of Family Medicine, University of Michigan, Ann Arbor, MI; 3Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI; 4Department of Psychology, Oakland University, Rochester, MI



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Study Objectives:

To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up.

Design:

Randomized controlled parallel trial.

Setting:

N/A.

Participants:

Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years).

Interventions:

Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15).

Measurements and Results:

Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P < 0.001) and were classified as “in remission” from insomnia at follow-up (P < 0.05). Posttreatment effect sizes on most daytime symptoms were large (Cohen d = 0.8–2.5) for CBTI-Phone patients and small to moderate (Cohen d = -0.1–0.6) for IPC patients. All CBTI-Phone patients completed posttreatment and 12-wk follow-up assessments, but three IPC patients discontinued the study.

Conclusions:

The findings provide preliminary support for telephone-delivered CBTI in the treatment of chronic insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support.

Citation:

Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362.

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