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Effectiveness of a Multicomponent Group Treatment for Insomnia

Published online by Cambridge University Press:  16 June 2009

Elisabeth Schramm ,
Fritz Hohagen ,
Jutta Backhaus ,
Stefanie Lis  and
Mathias Berger
Elisabeth Schramm
Affiliation:
University of Freiburg, Germany
Fritz Hohagen
Affiliation:
University of Freiburg, Germany
Jutta Backhaus
Affiliation:
University of Freiburg, Germany
Stefanie Lis
Affiliation:
University of Freiburg, Germany
Mathias Berger
Affiliation:
University of Freiburg, Germany
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Abstract

The present study evaluates a multifaceted cognitive-behavioral group treatment in a routine clinical setting. The program consists of directly sleep related strategies such as sleep education, sleep restriction, stimulus control, relaxation, and cognitive restructuring. Also included are techniques that target illness maintaining factors such as stress-management, problem solving skills, and increase of activities. Twenty-eight physician-referred outpatients with chronic primary insomnia according to DSM-III-R criteria attended 11 weekly therapy-sessions. Results were obtained on a subjective and objective level using a sleep diary, questionnaires, and polysomnography, respectively. Pre- and post-treatment comparisons indicated significant changes on all main sleep diary variables, i.e. total sleep time, sleep efficiency, number of awakenings, sleep onset latency and wake after sleep onset, as well as for the global subjective sleep quality. Maximum improvement was reached after the more directly sleep-related part of the program. In addition, the intervention helped patients to reduce the amount and frequency of sleeping aids over time and improved their daytime-functioning. Subjective therapeutic gains were maintained at 3- and 12-month follow-ups. No significant treatment effects could be obtained on polysomnographic measures, taking into account that the baseline values were already in the normative range. After the intervention the patients were able to give a more realistic evaluation of their sleep. These results suggest that a multicomponent psychological treatment is beneficial for the improvement of sleep quality on a subjective level.

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 23 , Issue 2 , April 1995 , pp. 109 - 127
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1995

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References

American Sleep Disorders Association. (1990). International Classification of Sleep Disorders (ICSD). Kansas: Allan Press Inc. Lawrence.Google Scholar
Buysee, D.J., Reynolds, C.F. III, Monk, T.H., Berman, S.R. and Kupfer, D.J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research 28, 193–213.CrossRefGoogle Scholar
Carskadon, M., Dement, W.C., Mitler, M.M., Guilleminault, C., Zarcone, V.P., Spiegel, R. (1976). Self-report versus sleep laboratory findings in 122 drug-free subjects with the complaint of chronic insomnia. American Journal of Psychiatry 133, 1382–1388.Google Scholar
Davies, D.B. (1989). A multiple treatment approach to the group treatment of insomnia: a follow-up study. Behavioural Psychotherapy 17, 323–331.CrossRefGoogle Scholar
Edinger, J.D., Hoelscher, T.H., Marsh, G.R., Lipper, S. and Ionescu-Pioggia, M. (1992). A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults. Psychology and Aging 7, 282–289.CrossRefGoogle ScholarPubMed
Engle-Friedman, M., Bootzin, R.R., Hazlewood, L. and Tsao, C. (1992). An evaluation of behavioral treatments for insomnia in older adults. Journal of Clinical Psychology 48, 77–90.3.0.CO;2-J>CrossRefGoogle Scholar
Eysenck, H.J. (1960). The Structure of Human Personality. London: Methuen.Google Scholar
Eysenck, H.J. (1967). The Biological Basis of Human Personality. Springfield, Ill: Thomas.Google Scholar
Fahrenberg, J., Hampel, R. and Selg, H. (1989). Das Freiburger Persönlichkeitsinventar FPI. 5. Aufl. Göttingen: Hogrefe.Google Scholar
Hoelscher, T.J. and Edinger, J.D. (1988). Treatment of sleep-maintenance insomnia in older adults: sleep period reduction, sleep education, and modified stimulus control. Psychology and Aging 3, 258–263.CrossRefGoogle ScholarPubMed
Hohagen, F., Rink, K., Schramm, E., Riemann, D., Weyerer, S. and Berger, M. (1993). Prevalence and treatment of insomnia in general practice—a longitudinal study. European Archives of Psychiatry and Clinical Neuroscience 242, 325–336.CrossRefGoogle ScholarPubMed
Hohenberger, E. and Schindler, L. (1984). Ein verhaltenstherapeutisches Programm zur Behandlung von Schlafstörungen. In Brengelmann, J.C. and Bühringer, G. (Eds). Therapieforschung für die Praxis. Themen der 10. Verhaltenstherapiewoche. München: Röttger Verlag.Google Scholar
Jacobs, G.D., Benson, H. and Friedman, R. (1993). Home-based central nervous system assessment of a multifactor behavioral intervention for chronic sleep-onset insomnia. Behavior Therapy 24, 159–174.CrossRefGoogle Scholar
Jacobs, G.D., Rosenberg, P.A., Friedman, R., Matheson, J., Peavy, G.M., Domar, A.D. and Benson, H. (1993) Multifactor behavioral treatment of chronic sleep-onset insomnia using stimulus control and the relaxation response. Behavior Modification 17, 498–509.CrossRefGoogle ScholarPubMed
Kales, A., Soldatos, C., Bixler, E.O. and Kales, J.D. (1983). Rebound insomnia and rebound anxiety: a review. Pharmacology 26, 121–137CrossRefGoogle ScholarPubMed
Lacks, P. (1987). Behavioural Treatment for Persistent Insomnia. Elmsford, NY: Pergamon Press.Google Scholar
Lacks, P. and Morin, C.M. (1992). Recent advances in the assessment and treatment of insomnia. Journal of Consulting and Clinical Psychology 60, 586–594.CrossRefGoogle ScholarPubMed
McCall, W.V. and Edinger, J.D. (1992) Subjective total insomnia: and example of sleep state misperception. Sleep 15, 71–73.Google ScholarPubMed
McClusky, H.Y., Milby, J.B., Switzer, P.K., Williams, V. and Wooten, V. (1991). Efficacy of behavioral versus triazolam treatment in persistent sleep-onset insomnia. American Journal of Psychiatry 148, 121–126.Google ScholarPubMed
Mendelson, W.B. (1993). Insomnia and related sleep disorders. Psychiatric Clinics of North America 16, 841–851.CrossRefGoogle ScholarPubMed
Morawetz, D. (1989). Behavioral self-help treatment for insomnia: a controlled evaluation. Behavior Therapy 20, 365–379.CrossRefGoogle Scholar
Morin, C.M., Gaulier, B., Barry, T. and Kowatch, R.A. (1992). Patients' acceptance of psychological and pharmacological therapies for insomnia. Sleep 15, 302–305.CrossRefGoogle ScholarPubMed
Morin, C.M., Kowatch, R.A., Barry, T. and Walton, E. (1993). Cognitive behavior therapy for late-life insomnia. Journal of Consulting and Clinical Psychology 61, 137–146.CrossRefGoogle ScholarPubMed
Morin, C.M., Stone, J., Maghakian, C., Astruc, M., Mercer, J. and Brink, D. (1993). Cognitive-behavior therapy and pharmacotherapy for late-life insomnia: a placebo-controlled trial.Paper presented at the annual meeting of the Association of Professional Sleep Societies, Los Angeles, June.Google Scholar
National Institutes of Health (1984). Drugs and insomnia: The use of medication to promote sleep. Journal of the American Medical Association 18, 2410–2414.Google Scholar
Rechtschaffen, A. and Kales, A. (1968). A manual of standardized terminology, techniques, and scoring system for sleep stages in human subjects. Los Angeles, University of California, Brain Information Service/Brain Research Institute.Google Scholar
Reynolds, C.F., Kupfer, D.J., Buysse, D.F. and Coble, P. A. (1991). Subtyping DSM-III-R primary insomnia: a literature review by the DSM-IV work group on sleep disorders. American Journal of Psychiatry 148, 432–438.Google Scholar
Schramm, E., Hohagen, F., Grasshoff, U., Riemann, D., Hajak, G., Weess, H.G. and Berger, M. (1993). Test-retest reliability and validity of a Structured Interview for Sleep Disorders according DSM-III-R (SIS-D). American Journal of Psychiatry 150, 867–872.Google Scholar
Trinder, J. (1988). Subjective insomnia without objective findings: a pseudo diagnostic classification? Psychological Bulletin 103, 87–94.CrossRefGoogle ScholarPubMed
Woolfolk, R.L. and McNulty, T.F. (1983). Relaxation treatment for insomnia: a component analysis. Journal of Consulting and Clinical Psychology 51, 495–503.CrossRefGoogle ScholarPubMed
Zerssen, D.V. (1976a). Die Befindlichkeitsskala. Weinheim: Beltz Test.Google Scholar
Zerssen, D.V. (1976b). Die Beschwerden-Liste. Weinheim: Beltz Test.Google Scholar
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