RESIDENT: Reviewing Outcomes of a New Group Cognitive Behavior Therapy for Insomnia (CBTi) Program

Objectives

1. Gain an understanding of the components of a CBTi program;
2. Review early outcome data for a new Group CBTi program at the University of Alberta; and
3. Become aware of indications for CBTi and the potential for its increased implementation.

Literature References

1. Internet-based cognitive–behavioural therapy for insomnia (ICBT-i): a meta-analysis of randomised controlled trials. Yuan-yuan et al.
   BMJ Open. 2016; 6(11). Nov 30 2016.
2. Effect of a Web-based Cognitive Behavioural Therapy for Insomnia Intervention with 1 Year Follow-up A Randomized Controlled Trial.
   Ritterband et al. JAMA Psychiatry. 2017;74(1):68-75.
3. Current Treatment of Comorbid Insomnia and Obstructive Sleep Apnea With CBTI and PAP-Therapy: A Systematic Review. Bahr K,
   Cámara RJA, Gouveris H, Tuin I. Front Neurol. 2018 Oct 29;9:804.
4. Internet-delivered cognitive-behavioral therapy for insomnia and comorbid symptoms. Hagatun S, et al. Internet Interv. 2018 Feb
   21;12:11-15
5. Treating Chronic Insomnia in Postmenopausal Women: A Randomized Clinical Trial Comparing Cognitive-Behavioral Therapy for
   Insomnia (CBTI), Sleep Restriction Therapy, and Sleep Hygiene Education. Drake CL, et al. Sleep. 2018 Nov 13.

Abstract

Want to sleep better? You’re not alone!

Insomnia and poor sleep are very common societal complaints and can be present in individuals with and without sleep-related
disorders. It is well known that poor sleep is a symptom of both psychiatric as well as general medical illnesses. Impaired sleep has
broad effects on worsening physical and psychological symptoms, and it contributes to increased morbidity and mortality of numerous
diseases. This is in addition to reduced social functioning, economic productivity, and overall lower quality of life.

Historically, multiple treatments have been employed to combat insomnia related concerns. These often involve pharmacotherapy
with sedatives and hypnotics that, while useful for a subset of the population, can be either insufficient, ineffective or bring with them
concerning adverse effects.

CBTi is increasingly being recognized as the recommended treatment modality for primary insomnia, and is also gaining traction as
benefitting other conditions where sleep is a concern. Beyond its success for targeting insomnia, its value is bolstered by the
incorporation of long-lasting psychotherapeutic elements. Furthermore, less polypharmacy and reduced medication dependence are
often seen.

In 2018, a new program offering group CBTi began at the University of Alberta Hospital’s Psychiatry Department. This is a joint effort
between Psychology and Psychiatry, which is expanding on the already established one-on-one CBTi treatment available.
This presentation is intended to summarize CBTi as a treatment, introduce the structure of the Group CBTi program, and review early
qualitative and quantitative data.