Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Feb;49:101230.
doi: 10.1016/j.smrv.2019.101230. Epub 2019 Nov 9.

Changes in Dysfunctional Beliefs About Sleep After Cognitive Behavioral Therapy for Insomnia: A Systematic Literature Review and Meta-Analysis

Affiliations
Free PMC article
Review

Changes in Dysfunctional Beliefs About Sleep After Cognitive Behavioral Therapy for Insomnia: A Systematic Literature Review and Meta-Analysis

Manu Thakral et al. Sleep Med Rev. .
Free PMC article

Abstract

Cognitive behavioral therapy for insomnia (CBT-I) is the preferred treatment for chronic insomnia and sleep-related cognitions are one target of treatment. There has been little systematic investigation of how sleep-related cognitions are being assessed in CBT-I trials and no meta-analysis of the impact of CBT-I on dysfunctional beliefs about sleep, a core cognitive component of treatment. Academic Search Complete, Medline, CINAHL and PsychInfo from 1990 to 2018 were searched to identify randomized controlled trials of CBT-I in adults (≥18 years) reporting some measure of sleep-related cognitions. Sixteen randomized controlled trials were identified comparing 1134 CBT-I and 830 control subjects. The Dysfunctional Beliefs and Attitudes about Sleep Scale was utilized almost exclusively to assess sleep-related cognitions in these trials. Hedge's g at 95% confidence interval (CI) was calculated to assess CBT-I effect size at post-treatment compared to controls. CBT-I significantly reduced dysfunctional beliefs about sleep (g = -0.90, 95% CI -1.19, -0.62) at post-treatment. Three trials contributed data to estimate effect size for long-term effects (g = -1.04, 95% CI -2.07, -0.02) with follow up time ranging from 3 to 18 mo. We concluded that cognitive behavioral therapy for insomnia has moderate to large effects on dysfunctional beliefs about sleep.

Keywords: CBT-I; Cognitive behavioral therapy; DBAS; Dysfunctional beliefs about sleep; Insomnia; Sleep-related cognitions.

Conflict of interest statement

Conflicts of Interest Dr. Von Korff was the Principal Investigator of grants to Group Health Research Institute (GHRI) now Kaiser Permanente Washington Health Research Institute, from Pfizer and the Campbell Alliance Group. Dr. Morin has served as a consultant for Abbott, Merck, Pfizer, and Phillips, and received research support from Idorsia. The remaining authors have no conflicts of interest to report.

Similar articles

See all similar articles

Publication types

LinkOut - more resources

Feedback