Does cognitive-behavioral insomnia therapy alter dysfunctional beliefs about sleep?

Study Objectives: This study was conducted to exam the degree to which cogn itive-behavioral insomnia therapy (CBT) reduces dysfunctional beliefs about sleep and to determine if such cognitive changes correlate with sleep impr ovements. Design: The study used a double-blind, placebo-controlled design in which p articipants were randomized to CBT progressive muscle relaxation training o r a sham behavioral intervention. Each treatment was provided in 6 weekly, 30-60-minute individual therapy sessions. Setting: The sleep disorders center of a large university medical center. Participants: Seventy-five individuals (ages 40 to 80 years of age) who met strict criteria for persistent primary sleep-maintenance insomnia were enr olled in this trial. Interventions: N/A Measurements and Results: Participants completed the Dysfunctional Reliefs and Attitudes About Sleep (DBAS) Scale, as well as other assessment procedu res before treatment, shortly after treatment, and at a six-month follow-up . Items composing a factor-analytically derived DBAS short form (DBAS-SF) w ere then used to compare treatment groups across time points. Results showe d CBT produced larger changes on the DBAS-SF than did the other treatments, and these changes endured through the follow-up period. Moreover, these co gnitive changes were correlated with improvements noted on both objective a nd subjective measures of insomnia symptoms, particularly within the CBT gr oup. Conclusions: CBT is effective for reducing dysfunctional beliefs about slee p and such changes are associated with other positive outcomes in insomnia treatment.