Treating primary insomnia: clinical effectiveness and predictors of outcomes on sleep, daytime function and health-related quality of life

J Clin Psychol Med Settings. 2011 Sep;18(3):312-21. doi: 10.1007/s10880-011-9250-7.


Primary insomnia, as defined by DSM-IV-TR, refers to a persistent sleep disturbance which is not connected to a current psychiatric or physical condition, but significantly impairs social and occupational functioning. This study explored the impact of Cognitive Behavioral Therapy for Insomnia (CBT-i) on sleep, daytime functioning and health-related quality of life (HRQoL). Next, we investigated which factors predicted positive treatment outcome by examining demographics, insomnia characteristics, baseline levels of daytime function, HRQoL, sleep-disruptive beliefs and psychological health on post-treatment sleep quality, daytime function and HRQoL. 138 consecutive primary insomnia patients completed questionnaires pre- and post-treatment and at 6 months follow-up. After CBT-i, robust clinical improvements were observed in sleep, daytime function and HRQoL, regardless of age, gender, type or duration of the complaint. Patients with pre-treatment severe insomnia, pronounced daytime impairment and low psychological well-being benefited most.

MeSH terms

  • Activities of Daily Living / psychology*
  • Adaptation, Psychological
  • Adult
  • Age Distribution
  • Aged
  • Attitude to Health
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Sex Distribution
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Sleep*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult