Nature and Science of Sleep (Jul 2023)
Comparison of Acceptance and Commitment Therapy (ACT) and Cognitive Behavior Therapy (CBT) for Chronic Insomnia: A Pilot Randomized Controlled Trial
Abstract
Jung-Won Shin,1,* Seonyeop Kim,2,* Yoon Jung Shin,2 Bomi Park,2 Sunyoung Park2 1Department of Neurology, Memory Center, Bundang CHA Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea; 2Graduate School of Clinical Counselling Psychology, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea*These authors contributed equally to this workCorrespondence: Jung-Won Shin, Department of Neurology, CHA Bundang Medical Center, CHA University, 59 Yatap-Dong, Bundang-Gu, Seongnam-si, Gyeonggi-do, 463-712, Republic of Korea, Tel +82-31-780-5058, Email [email protected]: Acceptance and Commitment Therapy (ACT) is part of the third wave of cognitive behavior therapy, and has six core components: acceptance, cognitive defusion, self as context, being present, values, and committed behavior. This study aimed to examine the efficacy of ACT for insomnia compared with cognitive behavior therapy for insomnia (CBT-I) in patients with chronic primary insomnia.Methods: The study recruited patients with chronic primary insomnia from a university hospital between August 2020 and July 2021. Thirty patients were enrolled and randomly assigned to receive either ACT (n = 15) or CBT-I (n = 15). Interventions were performed over four weeks, with four sessions of face-to-face therapy and four sessions of online therapy. The outcomes were measured using a sleep diary and a questionnaire.Results: Post-intervention, the ACT and CBT-I groups had significantly improved sleep quality, insomnia severity, depression, beliefs about sleep, sleep onset latency (SOL), and sleep efficacy (SE) (p < 0.05). However, anxiety was significantly reduced in the ACT group (p = 0.015), but not in the CBT-I group.Conclusion: ACT had a significant effect on primary insomnia and secondary symptoms, especially anxiety related to insomnia. These findings suggest that ACT could be a potential intervention for individuals who do not respond to CBT-I, who have high anxiety regarding sleep problems.Keywords: insomnia, cognitive behavior therapy, acceptance and commitment therapy
