title: Sleepless in Sweden: a single subject study of effects of cognitive therapy for insomnia on three adolescents.
abstract: BACKGROUND
  Sleeping difficulties are an increasing problem for youths, but there is a lack of treatment research for this age group.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effects of Cognitive Therapy for Insomnia (CT-I) on youths with primary insomnia; this treatment has never been tested on youths before.
  
  
  METHODS
  The study was conducted according to an AB single-case experimental phase design, with pre-tests and post-tests. After 7-10 days of baseline assessment, three youths aged 16-18 (2 male) with primary insomnia participated in a 7-week long treatment. A sleep diary was used throughout the treatment. A follow-up assessment including one week with a sleep diary was conducted 3 months later. Visual inspection was used to analyze outcome.
  
  
  RESULTS
  Insomnia severity was greatly reduced for all participants after treatment. Daily measures showed that sleep onset latency was reduced for two participants but no change in total sleep time was confirmed. Daytime symptoms fluctuated for the participants. The insomnia-specific psychological processes were reduced to varying extents. These results were maintained at the follow-up measure.
  
  
  CONCLUSIONS
  CT-I may be a promising treatment for youths with insomnia and the treatment should be tested further in randomized controlled studies.
authors.affiliation: Örebro University, School of Law, Psychology and Social Work, Fakultetsgatan 1, Örebro 70182, Sweden. annika.norell@oru.se
authors.forename: Annika
authors.initials: A
authors.lastname: Norell-Clarke
authors.forename: Evalotta
authors.initials: E
authors.lastname: Nyander
authors.forename: Markus
authors.initials: M
authors.lastname: Jansson-Fröjmark
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001143:Arousal; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief / Q000379:methods*; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D013548:Sweden