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CBT-I and HT-I group therapy for adults with insomnia in comparison to those with insomnia and comorbid depression – a pilot study

Authors Schlarb AA, Faber J, Hautzinger M

Received 7 February 2018

Accepted for publication 21 May 2018

Published 21 September 2018 Volume 2018:14 Pages 2429—2438

DOI https://doi.org/10.2147/NDT.S164899

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Angelika Anita Schlarb,1 Jasmin Faber,1 Martin Hautzinger2

1Department of Clinical Psychology and Psychotherapy for Children and Adolescents, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany; 2Department of Clinical Psychology and Psychotherapy, Faculty of Science, Eberhard Karls University Tübingen, Tübingen, Germany

Purpose: The aim of this study was to examine the effectiveness of a combined cognitive-behavioral therapy for insomnia (CBT-I) and hypnotherapy for insomnia (HT-I) program for insomnia patients with or without additional depression regarding depressive symptoms and various sleep parameters.
Patients and methods: A sample of 63 patients suffering from insomnia received a six-session sleep intervention, which combined cognitive-behavioral and hypnotherapeutical elements. Due to violating exclusion criteria, data of 37 patients were analyzed. Ten patients had insomnia comorbid with depression, whereas 27 patients had insomnia only. Sleep diaries were implemented to measure various sleep parameters, whereas depressive symptomatology was assessed with the anxiety and depression scale and Symptom-Checklist-90-R at baseline, before and after the intervention, as well as at 3-months follow-up.
Results: Depressive symptoms decreased from pre to post measurement and follow-up for patients with insomnia comorbid with depression, whereas scores of patients with only insomnia remained relatively on a low level. Both groups showed a significant increase of sleep efficiency and a significant decrease of the duration of wake after sleep onset. However, only patients with insomnia and depression revealed a significant reduction of sleep-onset latency and a higher level of regeneration. Nondepressive insomniacs, on the other hand, showed a significant increase of performance from post measurement to follow-up. For both groups, no change over time was found for number of wake after sleep onset, total sleep time, mood in the morning and evening.
Conclusion: Combining CBT-I and HT-I is effective in reducing depressive symptoms and improving sleep. Therefore, nonresponders to other forms of therapy, eg, pharmacological, interpersonal, or cognitive-behavioral therapy, might benefit from the combined CBT-I/HT-I intervention.

Keywords: CBT-I, hypnotherapy, insomnia, depression, adults, intervention

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