VANCOUVER – Cognitive behavioral therapy (CBT) may reduce the incidence of insomnia symptoms in adolescents, according to study data presented at the 2019 World Sleep Congress, September 20-25, in Vancouver, British Columbia, Canada.
The study enrolled 242 adolescents (aged 12-18 years) with a family history of insomnia. All participants had subthreshold insomnia symptoms, reporting insomnia fewer than 3 times per week but at least once per month. Patients were randomly assigned 1:1 to either the group-based CBT intervention condition (n=121) or the non-active control condition (n=121). The group-based CBT intervention met weekly for 4 weeks. Study assessments were conducted at baseline and at 2 weeks, 6 months, and 12 months postintervention. Insomnia incidence was ascertained through clinical interview, and insomnia symptom severity was determined with the Insomnia Severity Index.
The mean (SD) participant age was 14.9 (1.76) years, and 43.4% were boys. The majority (94%) of patients assigned to receive CBT completed at least 3 of the 4 sessions. Attrition was low, with 218 (90.1%), 219 (90.5%), and 206 (85.1%) adolescents attending the 2-week, 6-month, and 12-month assessments, respectively. Over the 12-month follow-up, a lower incidence of both acute and chronic insomnia was observed in the intervention group compared with the control group (P =.001). At 2 weeks, significant improvements on the Insomnia Severity Index were observed in the intervention group over the control group (P =.024). These improvements were maintained at the 6- and 12-month follow-up timepoints. Decreased incidence of stress-related insomnia (P =.012), dysfunctional beliefs toward sleep (P =.048), and daytime sleepiness (P =.043) were also observed in the intervention group over the control group at 12 months.
These data support the use of a short-term CBT program to prevent adolescent insomnia. Further research is needed to identify the most effective means of introducing insomnia-focused CBT to at-risk adolescents. School-level CBT initiatives at level may have utility in reducing the insomnia burden among youths, investigators wrote.
Chan NY, Li SX, Zhang J, et al. Can we prevent insomnia: brief cognitive behavioral therapy in at-risk adolescents. Presented at: 2019 World Sleep Congress; September 20-25, 2019; Vancouver, Canada. Insomnia board 132.