Cognitive-behavioral therapy for insomnia in adolescents with comorbid psychiatric disorders: A clinical pilot study. (October 2020)

• Record Type: Journal Article
• Authors: Åslund, Lie; Lekander, Mats; Wicksell, Rikard K; Henje, Eva; Jernelöv, Susanna
• Is Part Of: Clinical child psychology and psychiatry. Volume 25:Number 4(2020)
• Page Start: 958
• Page End: 971
• Publication Date: 2020-10
• Subjects: Adolescent -- chronic pain -- cognitive-behavioral therapy -- comorbidity -- insomnia -- psychiatric disorders; Clinical child psychology -- Periodicals; Child psychiatry -- Periodicals; 618.9289
• DOI: 10.1177/1359104520929376
• Languages: English
• ISSNs: 1359-1045

Abstract

Background: Insomnia is common in adolescents and often comorbid with psychiatric disorders. This study evaluated changes in insomnia, sleep, and comorbid symptoms following cognitive-behavioral therapy for insomnia (CBT-I) in adolescents with comorbid psychiatric disorders and chronic pain. Methods: In this non-controlled clinical pilot study, participants ( n = 23, 78% female) were recruited from adolescent psychiatry and pediatric pain clinics. Assessments of self-reported insomnia, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency and depression, anxiety, functional disability, and pain intensity were completed at pre- and post-intervention and 3 months follow-up. Results: From pre- to post-intervention, statistically significant improvements were found for insomnia symptoms ( p < .001; d = 1.63), sleep onset latency ( p < .001; d = 1.04), wake after sleep onset ( p < .001; d = 0.38), total sleep time ( p = .015; d = 0.22), sleep efficiency ( p < .001; d = 1.00), depression ( p < .001; d = 0.87), and anxiety ( p = .001; d = 0.31). Only eight participants reported data at follow-up with maintained improvements for all measures. Conclusion: This study provides support that insomnia symptoms and sleep can improve following CBT-I delivered in a clinical setting and that co-occurring psychiatric symptoms can be reduced. The results should be interpreted with caution due to the uncontrolled conditions and limited sample size. Well-powered clinical trials are needed to validate the suggested effects.