Insomnia disorder, as defined by the DSM-5, is characterized by a dissatisfaction with sleep quality or quantity due to difficulty initiating and/or maintaining sleep, resulting in clinically significant distress or impairment in functioning. Insomnia is a common clinical condition with severe health consequences-prevalence rates range from 10 to 20% of the adult population for insomnia disorder, and 35 to 50% for insomnia symptoms. Evening circadian preference and depression/anxiety symptom severity may moderate the effect of CBT-I on depression and anxiety outcomes. Results are mixed on whether CBT-I (either alone or augmented with depression/anxiety treatment) is effective in improving overall MDD, GAD, and PTSD outcomes. SummaryĬBT-I is superior to traditional depression/anxiety treatment in improving insomnia symptoms among patients with comorbid psychiatric disorders. Insomnia plays a critical role in the onset and maintenance of depression and anxiety, and treating insomnia with CBT-I may improve global outcomes for patients with MDD, GAD, and PTSD.
Recent Findingsĭespite high comorbidity rates, current behavioral and pharmacological treatments for MDD, GAD, and PTSD do not substantially target or improve insomnia symptoms residual insomnia is exceedingly common even among patients who experience remission. We also examine potential moderators of CBT-I on depression and anxiety outcomes in this population.
With a focus on reviewing adequately powered randomized controlled trials, we present recent research on the potential of cognitive behavioral therapy for insomnia (CBT-I) to improve depression and anxiety outcomes among patients with insomnia and one of the following comorbid psychiatric disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), or posttraumatic stress disorder (PTSD).
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