The Effectiveness of the Cognitive Behavioral Group Therapy Based on Edinger and Carney’s Protocol on Insomnia and Bedtime Procrastination in Patients with Insomnia
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Abstract
Background and Objective: Due to the high incidence of insomnia in students and its effects on physical and psychological health, the present study was conducted to investigate the effectiveness of cognitive behavioral group therapy (CBGT) on insomnia and bedtime procrastination in students.
Materials and Methods: The research sample consisted of 160 students of Zanjan University of Medical Sciences, Zanjan, Iran. Then, participants who scored > 15 in Insomnia Severity Index (ISI) and < 45 in Symptom Checklist-25 (SCL-25) were selected. ISI and Bedtime Procrastination Scale (BPS) were performed at three time intervals. Eight 90-minute sessions of CBGT were performed on the experimental group based on Edinger and Carney's protocol, and the control group received a booklet on sleep hygiene. The data were analyzed by repeated measures analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA).
Results: CBGT was significantly related to the reduced insomnia severity and bedtime procrastination. The difference between the two interventions in outcome variables showed that CBGT was significantly more effective than educational intervention in decreasing the rate of insomnia, but the difference between the two interventions was not significant in terms of bedtime procrastination. In other words, CBGT had a significant effect on study outcome and it was more effective than educational intervention.
Conclusion: Based on the Edinger and Carney’s protocol, CBGT was effective in reducing insomnia severity, but it did not directly affect bedtime procrastination. It seems that the inclusion of modalities for addressing bedtime procrastination increases the effectiveness of this treatment specifically for insomnia in students.
References
Sadock B, Sadock V and Ruiz P. Kaplan and Sadock's Synopsis of psychiatry: behavioral sciences/clinical psychiatry, 11th edition. 2015.
Sadock B, Sadock V and Ruiz P. Kaplan and Sadock's comprehensive textbook of psychiatry, Wolters Kluwer Health, 2017
National Sleep Foundation Sleep in America Poll. Washington, DC: National Sleep Foundation 2005.
Wali SO, Krayem AB, Samman YS, Mirdad S, Alshimemeri AA, Almobaireek A. Sleep disorders in Saudi health care workers. Ann Saudi Med 1999; 19 (5):406-9.
Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002; 6 (2):97-111.
Samaranayake CB, Arroll B, Fernando AR. Sleep disorders, depression, anxiety and satisfaction with life among young adults: a survey of university students in Auckland, New Zealand. N. Z Med J 2014; 127, 13-22.
Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. J Paediatr Child Health 2012; 48(2):138-45.
Li L, Wang YY, Wang SB, Zhang L, Li L, Xu DD, Ng CH, Ungvari GS, Cui X, Liu ZM, De Li S, Jia FJ, Xiang YT. Prevalence of sleep disturbances in Chinese university students: a comprehensive meta-analysis. J Sleep Res. 2018; 27(3), 126-48
Jiang XL, Zheng XY, Yang J, Ye CP, Chen YY, Zhang ZG, Xiao ZJ. A systematic review of studies on the prevalence of Insomnia in university students. Public Health, 2015; 129 (12), 1579-84
Sing CY, Wong WS. Prevalence of Insomnia and Its Psychosocial Correlates among College Students in Hong Kong, Journal of American College Health, 2010; 59(3), 174-182
Moayedi F, Shahabjahanlu A, Rasa F, Sadeghi, P. Prevalence of Sleep Disorders among Medical Students. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 2015; 6(2), 894-98
Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013; 47(3):391-400.
Johansson P, Alehagen U, Svanborg E, Dahlstrom U, Brostrom A. Sleep disordered breathing in an elderly community-living population: relationship to cardiac function, insomnia symptoms and daytime sleepiness. Sleep Med. 2009; 10(9):1005-11.
Redeker NS, Jeon S, Muench U, Campbell D, Walsleben J, Rapoport DM. Insomnia symptoms and daytime function in stable heart failure. Sleep. 2010; 33(9):1210-6.
Sarsour K, Van Brunt DL, Johnston JA, Foley KA, Morin CM, Walsh JK. Associations of nonrestorative sleep with insomnia, depression, and daytime function. Sleep Med. 2010; 11(10):965-72.
Van Houdenhove L, Buyse B, Gabriels L, Van den Bergh O. 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; 18(3):312-21.
Carney CE, Moss TG, Lachowski AM, Atwood ME. Understanding mental and physical fatigue complaints in those with depression and insomnia. Behav Sleep Med. 2014; 12(4):272-89. 2014-01-20.
Fernandez-Mendoza J, Vgontzas AN. Insomnia and its impact on physical and mental health. Curr Psychiatry Rep. 2013; 15(12):418.
Sivertsen B, Krokstad S, Overland S, Mykletun A. The epidemiology of insomnia: associations with physical and mental health. The HUNT-2 study. J Psychosom Res. 2009; 67(2):109-16.
Zee PC, Turek FW. Sleep and health: Everywhere and in both directions. Arch Intern Med 2006; 166(16):1686-8.
Barakat D, Elwasify M, Elwasify M, Radwan D. Relation between insomnia and stress, anxiety, and depression among Egyptian medical students. Middle East Current Psychiatry, 2016; 23(3), 119-27
Taylor DJ, Bramoweth AD, Grieser EA, Jolyn I, Roane TB. Epidemiology of Insomnia in College Students: Relationship with Mental Health, Quality of Life, and Substance Use Difficulties. Behavior Therapy, 2013; 44, 339–348.
Zee PC, Turek FW. Sleep and health: Everywhere and in both directions. Arch Intern Med 2006; 166(16):1686-8.
Wali SO, Krayem AB, Samman YS, Mirdad S, Alshimemeri AA, Almobaireek A. Sleep disorders in Saudi health care workers. Ann Saudi Med, 1999; 19(5):406-9.
BaHammam A, Bin SA, Al-Faris E, Shaikh S. Sleep duration and its correlates in a sample of Saudi elementary school children. Singap Med J. 2006; 47(10):875-81.
Ikeda T, Nagai T, Kato-Nishimura K, Mohri I, Taniike M. Sleep problems in physically disabled children and burden on caregivers. Brain Dev. 2012; 34(3), 223-9.
Navelet Y. Insomnia in the child and adolescent. Sleep. 1996; 19 (3), 23-8.
Benca R. Diagnosis and treatment of chronic Insomnia: A review. Psychiatr Serv. 2005; 56:332-343.
Edinger J, Carney C. Overcoming insomnia: A cognitive behavioral approach, Therapist Guide (Treatment That Work), Oxford University Press, 2014.
Edinger J, Carney C. Overcoming insomnia: A cognitive behavioral approach, Work Book (Treatment That Work), 2nd Edition, Oxford University Press, 2014.
Okajima I, Komada Y, Inoue Y. A meta-analysis on the treatment effectiveness of cognitive behavioral therapy for primary insomnia. Sleep Biol Rhythms. 2011; 9 (1):24-34.
Ho FYY, Chung KF, Yeung WF, Ng TH, Kwan KS, Yung KP, et al. Self-help cognitive-behavioral therapy for insomnia: a meta-analysis of randomized controlled trials. Sleep Med Rev. 2015; 19,17-28.
Koffel E, Koffel J, Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep Med Rev. 2014; 19, 6-16.
Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2001; 2, 297–307.
Broers, V. Identifying and Supporting Bedtime Procrastinators: a Self-regulation Perspective Implementing Self-monitoring as Intervention. Unpublished master’s thesis, Utrecht University, Utrecht. (2014).
Najarian B, Davodi I. [Development and reliability of SCL-25; short form of SCL-90]. Journal of
Psychology, 2001; 18: 136-49.
Norell-Clarke A, Jansson-Frojmark M, Tillfors M, Hollandare F, Engstrom I. Group cognitive behavioural therapy for insomnia: Effects on sleep and depressive symptomatology in a sample with comorbidity, Behaviour Research and Therapy. 2015; 74, 80-93.
Tang NK, Goodchild CE, Salkovskis PM. Hybrid cognitive-behavior therapy for individuals with insomnia and chronic pain: A pilot randomized controlled trial, Behavior Research and Therapy. 2012; 15, 814-821.
Mottaghipour R, Kamkar A, Maredpoor AR. [The effectiveness of cognitive behavior therapy on the quality of sleep in elderly people with insomnia Disorder (Persian)]. Iranian Journal of Ageing. 2016; 11(2):234-243.
Castronovo V, Galbiati A, Sforza M, Poletti M, Giarolli L, Kuo T, Zucconi M, Manconi M, Hensley M, Morin C, Ferini-Strambi L. Long-term clinical effect of group cognitive behavioral therapy for insomnia: a case series study. Sleep Medicine, 2018; 47, 54-59
Harvey AG, Bélanger L, Talbot L, Eidelman P, BeaulieuBonneau S, Fortier-Brochu E, Ivers H, Lamy M, Hein K, Soehner AM, Mérette C, Morin CM. Comparative Efficacy of Behavior Therapy, Cognitive Therapy and Cognitive Behavior Therapy for Chronic Insomnia: A Randomized Controlled Trial. J Consult Clin Psychol. 2014; 82(4): 670–683
Shamse-Alizade N. Sleep disorders: Identifying disorders and sleep hygiene. 2015, Ghatre Publication, Tehran, Iran
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| Issue | Vol 3 No 3-4 (2018): Summer-Autumn | |
| Section | Original Article(s) | |
| Keywords | ||
| Cognitive behavior therapy Insomnia Sleep | ||
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