Cognitive-behavioral therapy for insomnia co-morbid with hearing impairment: a randomized controlled trial.
The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18-1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03-1.07) and sleep quality (d = 0.91-1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81-0.96) and lower anxiety (d = 1.29-1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53-77%) than WLC participants (0-7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.
School of Law, Psychology, and Social Work, Örebro University, SE-701 82, Örebro, Sweden. markus.jansson@oru.se
Markus
M
Jansson-Fröjmark
Steven J
SJ
Linton
Ida K
IK
Flink
Sarah
S
Granberg
Berth
B
Danermark
Annika
A
Norell-Clarke
D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D013548:Sweden; D014012:Tinnitus / Q000453:epidemiology / Q000523:psychology