title: Residual sleep beliefs and sleep disturbance following Cognitive Behavioral Therapy for major depression.
abstract: BACKGROUND
  Sleep disturbance is a commonly reported residual symptom after effective depression treatment. This residual sleep impairment, as well as the presence of problem levels of certain sleep beliefs, may be important for depressive relapse prevention, and as such should be addressed in treatment. The following study examined residual sleep disturbance and residual maladaptive sleep beliefs in those treated with Cognitive Behavior Therapy for depression.
  
  
  METHODS
  Participants (N = 24) were clinic patients seeking treatment for depression at a community clinic. Repeated measures analyses of variance tested pre- to posttreatment change on depression symptoms, general negative beliefs, sleep quality, and maladaptive sleep beliefs.
  
  
  RESULTS
  As expected, significant time effects were found for depressive symptoms and general negative beliefs. Sleep quality scores also decreased significantly at posttreatment; however, 92% of those no longer meeting depressive criteria continued to endorse residual sleep disturbance, according to an established clinical cutoff score of > 5 on a validated measure of sleep quality (the Pittsburgh Sleep Quality Index). There were no significant pre- to posttreatment changes for maladaptive sleep beliefs.
  
  
  CONCLUSIONS
  The results indicate that sleep disturbance and maladaptive sleep-related beliefs remain a problematic residual symptom of remitted depression. These findings are discussed with reference to improving cognitive behavioral treatments for depression in order to help reduce rates of residual sleep problems.
authors.affiliation: Ryerson University, University of Toronto, Toronto, Ontario, Canada. ccarney@psych.ryerson.ca
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Carney
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Harris
authors.forename: Joey
authors.initials: J
authors.lastname: Friedman
authors.forename: Zindel V
authors.initials: ZV
authors.lastname: Segal
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003469:Culture; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents