Cognitive-behavioral treatment of insomnia and depression in adolescents: A pilot randomized trial.
We tested whether augmenting conventional depression treatment in youth by treating sleep issues with cognitive behavioral therapy for insomnia (CBT-I) improved depression outcomes. We randomized youth 12-20 years of age to 10 weekly sessions of a sleep hygiene control condition (SH) combined with CBT for depression (CBT-D) (n = 20), or an experimental condition consisting of CBT-I combined with CBT-D (n = 21). We assessed outcomes through 26 weeks of follow-up and found medium-large effects favoring the experimental CBT-I arm on some sleep outcomes (actigraphy total sleep time and Insomnia Severity Index "caseness") and depression outcomes (higher percentage recovered, faster time to recovery), but little effect on other measures. Total sleep time improved by 99 min from baseline to week 12 in the CBT-I arm, but not in the SH arm. In addition, our pilot yielded important products to facilitate future studies: the youth-adapted CBT-I program; the study protocol; estimates of recruitment, retention, and attrition; and performance and parameters of candidate outcome measures. ClinicalTrials.gov Identifier NCT00949689.
Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA. Electronic address: greg.clarke@kpchr.org.
Greg
G
Clarke
University of California at Berkeley (UCB) Golden Bear Sleep and Mood Research Clinic, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA.
Eleanor L
EL
McGlinchey
University of California at Berkeley (UCB) Golden Bear Sleep and Mood Research Clinic, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA.
Kerrie
K
Hein
Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA.
Christina M
CM
Gullion
Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA.
John F
JF
Dickerson
Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA.
Michael C
MC
Leo
University of California at Berkeley (UCB) Golden Bear Sleep and Mood Research Clinic, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA.
Allison G
AG
Harvey
D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D002648:Child; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
Adolescents; CBT; Depression; Insomnia; Treatment