title: Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial.
abstract: BACKGROUND
  Insomnia disorder is common and often co-morbid with mental health conditions. Cognitive behavioural therapy (CBT) for insomnia is effective, but is rarely implemented as a discrete treatment. The aim of this study was to evaluate the effectiveness of brief CBT groups for insomnia compared to treatment as usual (TAU) for insomnia delivered by mental health practitioners in a primary-care mental health service.
  
  
  METHODS
  A total of 239 participants were randomized to either a five-session CBT group or to TAU. Assessments of sleep and of symptoms of depression and anxiety were carried out at baseline, post-treatment and at 20 weeks. Primary outcome was sleep efficiency post-treatment.
  
  
  RESULTS
  Group CBT participants had better sleep outcomes post-treatment than those receiving TAU [sleep efficiency standardized mean difference 0.63, 95% confidence interval (CI) 0.34-0.92]. The effect at 20 weeks was smaller with a wide confidence interval (0.27, 95% CI -0.03 to 0.56). There were no important differences between groups at either follow-up period in symptoms of anxiety or depression.
  
  
  CONCLUSIONS
  Dedicated CBT group treatment for insomnia improves sleep more than treating sleep as an adjunct to other mental health treatment.
authors.affiliation: Research Department of Clinical,Educational and Health Psychology,University College London,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Cape
authors.affiliation: Camden and Islington NHS Foundation Trust,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Leibowitz
authors.affiliation: Research Department of Clinical,Educational and Health Psychology,University College London,London,UK.
authors.forename: C
authors.initials: C
authors.lastname: Whittington
authors.affiliation: Nuffield Department of Clinical Neurosciences/ Sleep & Circadian Neuroscience Institute,University of Oxford,Oxford,UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Espie
authors.affiliation: Research Department of Clinical,Educational and Health Psychology,University College London,London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Pilling
mesh_terms: D000328:Adult; D001007:Anxiety; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cognitive behavioural therapies; outcome studies; primary care; randomized controlled trial; sleep disorders