2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: The interaction between cognitive and behavioral factors is the key mechanism involved in the perpetuation of insomnia.
• Essence of therapy: Cognitive-behavioral therapy for insomnia focuses on teaching techniques to modify sleep disruptive behaviors and cognitions that interfere with normal sleep and contribute to insomnia.
• Length: approx. 6 sessions

 

Treatment Resources

Editors: John Otis, PhD

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

Books Available for Purchase Through External Sites

• Behavioral Treatments for Sleep Disorders: A Comprehensive Primer of Behavioral Sleep Medicine Interventions (Perlis, Aloia, & Kuhn)
• Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach, Therapist Guide (Treatments That Work; Edinger & Carney)
• Treatment Plans and Interventions for Insomnia: A Case Formulation Approach (Manber & Carney)

 

Training Materials and Workshops

• Principles and Practice of Sleep Medicine (Kryger, Roth, & Dement; in press)
• Insomnia: A Clinical Guide to Assessment and Treatment (Morin & Espie)
• Etiology of Insomnia (Perlis et al.; in press)
• Cognitive Behavioral Treatment of Insomnia: A Session by Session Guide (Perlis et al.)
• Insomnia: Principles and Management (Szuba, Kloss, & Dinges)

Measures, Handouts and Worksheets

• Sleep Timing Questionnaire (Monk et al.)
• Fatigue Severity Scale (Krupp et al.)
• Consensus Sleep Diary (Carney et al.)
• Epworth Sleepiness Scale (Johns)
• Pittsburgh Sleep Quality Index (Buysse et al.)
• Insomnia Severity Index (Bastien, Vallières, & Morin)
• Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16; Morin, Vallières, & Ivers)
• Sleep Hygiene Index (Mastin, Bryson, & Corwyn)
• The Sleep Condition Indicator (Espie et al.)

Self-help Books

• Quiet Your Mind and Get to Sleep: Solutions to Insomnia for those with Depression, Anxiety, or Chronic Pain (Carney & Manber)
• No More Sleepless Nights (Hauri & Linde)
• Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep (Mindell)
• Sleepio (an online sleep improvement program; Espie, Kyle, & Sheaves)

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

• CBT-i Coach (US Dept of Veterans Affairs)

Clinical Trials

• A randomized controlled trial of cognitive behavioral therapy for insomnia: An effective treatment for comorbid insomnia and depression (Ashworth et al., 2015)
• An open trial of cognitive therapy for chronic insomnia (Harvey et al., 2007)
• Randomized placebo-controlled trial of cognitive behavioral therapy and armodafinil for insomnia after cancer treatment (Roscoe et al., 2015)

Meta-analyses and Systematic Reviews

• Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age (Irwin, Cole, & Nicassio, 2006)
• Nonpharmacological interventions for insomnia: A meta‐analysis of treatment efficacy (Morin, Culbert, & Schwartz, 1994)
• Identifying effective psychological treatments for insomnia: a meta‐analysis (Murtagh & Greenwood, 1995)
• A meta-analysis on the treatment effectiveness of cognitive behavioral therapy for primary insomnia (Okajima, Komada, & Inoue, 2011)

Other Treatment Resources

• Hyperarousal and insomnia (Bonnet & Arand, 1997)
• A neurobiological model of insomnia (Buysse et al., 2011)
• Cognitive-behavioral therapy for primary insomnia (Edinger & Means, 2005)
• A cognitive model of insomnia (Harvey, 2002)
• Insomnia, psychiatric disorders, and the transdiagnostic perspective (Harvey, 2008)
• The delivery of behavioral sleep medicine to college students (Kloss et al., 2011)
• Sleep patterns and predictors of disturbed sleep in a large population of college students (Lund et al., 2010)
• Nonpharmacologic treatment of chronic insomnia: An American Academy of Sleep Medicine review (Morin et al., 1999)
• Chronic insomnia (Morin & Benca, 2012)
• Self-reported sleep disturbance as a prodromal symptom in recurrent depression (Perlis et al., 1997)
• The hyperarousal model of insomnia: A review of the concept and its evidence (Riemann et al., 2010)
• Clinical guideline for the evaluation and management of chronic insomnia in adults (Schutte-Rodin et al., 2008)
• Who is a candidate for cognitive-behavioral therapy for insomnia? (Smith & Perlis, 2006)
• A behavioral perspective on insomnia treatment (Spielman, Caruso, & Glovinsky, 1987)