Acceptance and Commitment Therapy, Combined with Bedtime Restriction, versus Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Pilot Trial.

Hertenstein, Elisabeth; Trinca, Ersilia; Schneider, Carlotta L; Fehér, Kristoffer D; Johann, Anna F; Nissen, Christoph (2024). Acceptance and Commitment Therapy, Combined with Bedtime Restriction, versus Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Pilot Trial. Psychotherapy and psychosomatics, 93(2), pp. 114-128. Karger 10.1159/000535834

Full text not available from this repository.

INTRODUCTION

Cognitive behavioral therapy for insomnia (CBT-I) is the current first-line treatment for insomnia. However, rates of nonresponse and nonremission are high and effects on quality of life are only small to moderate, indicating a need for novel treatment developments. We propose that Acceptance and Commitment Therapy (ACT) addresses core pathophysiological pathways of insomnia. ACT therefore has the potential to improve treatment efficacy when combined with bedtime restriction, the most effective component of CBT-I. The aim of this study was to compare the efficacy of ACT for insomnia combined with bedtime restriction (ACT-I) and CBT-I in improving insomnia severity and sleep-related quality of life.

METHODS

Sixty-three patients with insomnia disorder (mean age 52 years, 65% female, 35% male) were randomly assigned to receive either ACT-I or CBT-I in a group format. The primary outcomes were insomnia severity (Insomnia Severity Index) and sleep-related quality of life (Glasgow Sleep Impact Index). Outcomes were assessed before randomization (T0), directly after treatment (T1), and at 6-month follow-up (T2).

RESULTS

The results indicated significant, large pre-to-post improvements in both groups, for both primary and secondary outcomes. Improvements were maintained at the 6-month follow-up. However, there was no significant group by time interactions in linear mixed models, indicating an absence of differential efficacy. On a subjective treatment satisfaction scale, patients in the ACT-I group indicated significantly greater satisfaction with their improvement of several aspects of health including their energy level and work productivity.

CONCLUSIONS

The results suggest that ACT-I is feasible and effective, but not more effective than CBT-I for the improvement of insomnia severity and sleep-related quality of life. Future studies are needed to assess whether ACT-I is noninferior to CBT-I and to shed light on mechanisms of change in both treatments.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center 04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
UniBE Contributor:	Hertenstein, Elisabeth, Trinca, Ersilia, Schneider, Carlotta Louisa, Nissen, Christoph
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0033-3190
Publisher:	Karger
Language:	English
Submitter:	Pubmed Import
Date Deposited:	06 Mar 2024 11:05
Last Modified:	06 Apr 2024 00:16
Publisher DOI:	10.1159/000535834
PubMed ID:	38417415
Uncontrolled Keywords:	Acceptance and commitment therapy Cognitive behavioral therapy Insomnia Psychotherapy Sleep
URI:	https://boris.unibe.ch/id/eprint/193611