SEATTLE, WA—Participants of single session, nurse-led group cognitive behavioral therapy for insomnia (CBT-I) experienced improvements in sleep and reported high satisfaction with the program, according to data presented at SLEEP 2015 by Wendy R. Moore, BSN, RN, of the Department of Nursing, Mayo Clinic College of Medicine, Rochester, MN.
In this prospective study, patients with insomnia (n=60; 72% female, 28% male) participated in a group-based CBT-I program led by registered nurses in an accredited tertiary sleep center. Subjects ranged in age from 26.3– 88.8 years.
Patients completed sleep diaries, Pittsburg Insomnia Rating Scale (PIRS), and Dysfunctional Beliefs about Sleep (DBAS) questionnaires at baseline, and 2 months after CBT-I participation. Patient satisfaction and self-efficacy outcomes surveys were also conducted and pre- and post-program outcomes. The correlation between intervention use (≥3 vs. <3 times/week) and outcome differences (pre- vs. post-program) was assessed.
Study results showed statistically significant improvements in wake after sleep onset (median decrease 0.6 hours/day), sleep efficiency (median increase 6.5%), total sleep time (median increase 0.4 hours), PIRS (median decrease 8), DBAS (median decrease 0.9), and subjective responses regarding sleep quality. “There was no significant change in sleep latency or total time in bed,” added Moore, the study’s lead author.
Intervention use of ≥3 times/week vs. <3 times/week led to restoration/refreshment by sleep with relaxation technique use (median decrease 0 vs. 0.4), total sleep time with worry time use (median increase 0.9 hours vs. median decrease 0.6 hours), subjective sleep quality with self-talk use (median decrease 0.1 vs. median increase 0.4), sleep latency (median decrease 10.7 minutes vs. median increase 11.8 minutes), time in bed (median decrease 0.3 hours vs. median increase 1.2 hours), and DBAS scores (median decrease 1.3 vs. median decrease 0.7) with stimulus control use.
Ninety percent of participants reported feeling satisfied or very satisfied with the program; 67–73% reported that the program moderately impacted attitude, behavior, and insomnia management.
“Significant improvements were noted in sleep efficiency, wake after sleep onset, total sleep time, and subjective questions related to sleep quality, as well as DBAS and PIRS rating scales.” Moore said. Participants also “noted positive impact on self-improvement of insomnia.” She added, “Availability of CBT-I treatment is evolving with the emergence of non-traditional approaches.” This study shows the viability of a single-session, nurse-led format.