Effect of cognitive behavioral therapy for insomnia on sleep quality and cognitive function in patients with chronic insomnia disorder

Abstract

BackgroundInsomnia disorder has become a common disease in the current society. Cognitive Behavior Therapy for Insomnia （CBTI） is one of the non-drug treatment methods for insomnia disorder， but relevant studies of its effect on sleep quality and cognitive function of patients with insomnia disorder are limited.ObjectiveTo explore the effects of CBTI on sleep quality and cognitive function in patients with insomnia disorder， so as to provide references for non-drug treatment of insomnia disorder.MethodsA total of 47 patients with insomnia disorder were recruited as the study subjects. They all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and have visited Sichuan Mental Health Center from January 2021 to October 2022. The patients underwent CBTI for 6 weeks. Before the treatment， depression and anxiety symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） and Hamilton Anxiety Scale （HAMA）. Sleep status and cognitive function were assessed using Pittsburgh Sleep Quality Index （PSQI） and Montreal Cognitive Assessment （MoCA） before and 6 weeks after the treatment. Spearman correlation analysis was used to examine the correlation between the reduction of PSQI score and the increase of MoCA score after treatment.ResultsAfter the 6-week treatment， the factor scores and total score of PSQI across 6 subscales （the sleep quality， sleep onset time， sleep time， sleep efficiency， sleep disorder and daytime dysfunction） were lower than those before the treatment， and the score differences were of statistical significance （t=5.569~15.290， P<0.01）. Both factor and total scores of MoCA across 6 items （visuospatial and executive， naming， attention， language， abstraction and memory） were significantly higher than those before the treatment with score differences reaching statistical significance （t=-11.273~-4.277， P<0.01）. Spearman correlation analysis demonstrated that there was a positive correlation between the decrease in PSQI total score and the increase in MoCA total score after the 6-week CBTI treatment （r=0.323， P=0.027）.ConclusionCBTI may help improve sleep quality and cognitive function in patients with insomnia disorders. The improvement of sleep quality after CBTI intervention may be related to the improvement of cognitive function. ［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ216）］

Keywords

• insomnia
• cognitive behavior therapy for insomnia
• cognitive function
• sleep quality