Sleep medicine

Cognitive behavioral therapy for insomnia reduces differences between sleep tracker and diary measures in people with insomnia and depression

Updated

Abstract

Participants receiving cognitive behavioral therapy for insomnia (CBT-I) showed a greater reduction in actigraphy-diary discrepancies across all sleep metrics compared to those receiving sham therapy.

  • At baseline, sleep diary total sleep time was shorter by 1.1 hours compared to actigraphy.
  • Sleep onset latency and wake after sleep onset were longer in sleep diaries by an average of 21.64 minutes and 17.45 minutes, respectively.
  • CBT-I led to significant reductions in discrepancies in total sleep time, sleep onset latency, and sleep efficiency, with all differences being statistically significant.
  • Changes in sleep-related beliefs and attitudes during treatment mediated the differences in actigraphy-diary discrepancies for total sleep time, sleep onset latency, and sleep efficiency.
  • Discrepancy changes did not mediate improvements in insomnia symptoms.

Simplified

Full Text

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Funding

Competing interests

Declaration of competing interest Dr Krystal has received research grants from Janssen Pharmaceuticals, Axsome Pharmaceutics, Neurocrine Biosciences, Reveal Biosensors, The Ray and Dagmar Dolby Family Fund, and the National Institutes of Health; and reports consulting connections with Adare, Axsome Therapeutics, Big Health, Eisai, Evecxia, Ferring Pharmaceuticals, Galderma, Harmony Biosciences, Idorsia, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Millennium Pharmaceuticals, Merck, Neurocrine Biosciences, Neurawell, Pernix, Otsuka Pharmaceuticals, Sage, Takeda, Angelini. Dr Edinger has received funding from Merck and donated equipment from Philips Respironics to support his research; and serves a consultant to Somly, a company that provides an online treatment for insomnia. Dr Buysse has served as a paid consultant to National Cancer Institute, Pear Therapeutics, Sleep Number, Idorsia, Eisai, and Weight Watchers International. Dr. Buysse is an author of the Pittsburgh Sleep Quality Index, Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A), Brief Pittsburgh Sleep Quality Index (B-PSQI), Daytime Insomnia Symptoms Scale, Pittsburgh Sleep Diary, Insomnia Symptom Questionnaire, and RU_SATED (copyrights held by University of Pittsburgh). These instruments have been licensed to commercial entities for fees. He is also co-author of the Consensus Sleep Diary (copyright held by Ryerson University), which is licensed to commercial entities for a fee. He has received grant support from NIH, PCORI, AHRQ, and the VA. Over the past few years Dr Manber received royalties from Newharbinger ad from Guilford press for books she authored. Forest pharmaceutical and Wyeth pharmaceutical donated medications to the TRIAD study. Ms Spina, Drs Bei, Rajaratnam, and Thase report no conflicts.
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