Persistent primary insomnia (PPI) is a prevalent and debilitating sleep disorder which in middle-and older-aged adults typically presents as an unrelenting difficulty maintaining sleep. This project will evaluate the effectiveness of a cognitive-behavioral therapy (CBT) specifically designed for the treatment of sleep-maintenance insomnia.
The Specific Aims of this project include: (1) testing the effectiveness of CBT for treating the sleep-maintenance problems of middle- and older-aged PPI patients through comparisons of this treatment with an alternate behavioral therapy, relaxation therapy (RT) and a placebo control (PC) treatment; (2) comparing the treatment response of sleep-maintenance insomniacs who receive CBT on an immediate basis with those who receive this treatment after first receiving a placebo treatment; (3) comparing the effects of CBT, RT and PC on sleep architecture; and (4) comparing the effects of these three treatments on measures of anxiety, depressed mood, insomnia-related symptoms, and daytime functioning. Seventy-eight subjects between the ages of 40 and 80 will undergo polysomnographic evaluation, home sleep monitoring with a sleep assessment device, and sleep log monitoring. Subjects will also complete the Beck Depression Inventory (BDI) before treatment. By random assignment one third of the subjects will then receive CBT, a second third will be provided RT, and the remaining third will receive the PC. Each subject will be provided treatment in 6 weekly individual therapy sessions by one of two participating therapists. Immediately following treatment all pre- treatment measures will be repeated. Subjects assigned to CBT or RT will then complete a follow-assessment 6 months later. PC subjects will be provided 6 weeks of CBT and reassessed both at the conclusion of this therapy and again 6 months later. A series of multivariate statistics and tests of clinical significance will be conducted to address the Specific Aims noted above. Results will be useful for increasing understanding of primary sleep-maintenance insomnia and for improving treatment of this condition.
|Carney, Colleen E; Edinger, Jack D; Morin, Charles M et al. (2010) Examining maladaptive beliefs about sleep across insomnia patient groups. J Psychosom Res 68:57-65|
|Krystal, Andrew D; Edinger, Jack D (2010) Sleep EEG predictors and correlates of the response to cognitive behavioral therapy for insomnia. Sleep 33:669-77|
|Montserrat Sanchez-Ortuno, M; Edinger, Jack D (2010) A penny for your thoughts: patterns of sleep-related beliefs, insomnia symptoms and treatment outcome. Behav Res Ther 48:125-33|
|Edinger, Jack D; Wohlgemuth, William K; Radtke, Rodney A et al. (2007) Dose-response effects of cognitive-behavioral insomnia therapy: a randomized clinical trial. Sleep 30:203-12|
|Carney, Colleen E; Edinger, Jack D; Manber, Rachel et al. (2007) Beliefs about sleep in disorders characterized by sleep and mood disturbance. J Psychosom Res 62:179-88|
|Carney, Colleen E; Edinger, Jack D (2006) Identifying critical beliefs about sleep in primary insomnia. Sleep 29:444-53|
|Krystal, Andrew D; Edinger, Jack D; Wohlgemuth, William K et al. (2002) NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes. Sleep 25:630-40|
|Edinger, J D; Wohlgemuth, W K; Radtke, R A et al. (2001) Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA 285:1856-64|
|Edinger, J D; Wohlgemuth, W K; Radtke, R A et al. (2001) Does cognitive-behavioral insomnia therapy alter dysfunctional beliefs about sleep? Sleep 24:591-9|
|Wohlgemuth, W K; Edinger, J D; Fins, A I et al. (1999) How many nights are enough? The short-term stability of sleep parameters in elderly insomniacs and normal sleepers. Psychophysiology 36:233-44|