Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety

Abstract

Objective To evaluate the efficacy of hypnosis combined with cognitive behavior therapy for insomnia (CBT-I) in improving the symptoms of patients with chronic insomnia and anxiety. Methods Between March and May, 2018, 48 patients with chronic insomnia and moderate anxiety were recruited from the Psychology Clinic of our center and randomized into the observation group and control group. The patients in the observation group received hypnosis therapy combined with CBT-I for 6 weeks, and those in the control group were treated with CBT-I only. The patients were assessed for anxiety level and sleep quality using Self-Rating Anxiety Scale (SAS) and Pittsburg Sleep Quality Index (PSQI) before and immediately after the intervention, and at 1 month and 3 months after the intervention; Cardiopulmonary Coupling Sleep Quality Assessment System (CPC) was used to measure the sleep onset latency (SOL), time in bed (TIB), total sleep time (TST) and sleep efficiency (SE) of the patients at the same time points. Results At each of the time points after intervention, the patients in the observation group had lower SAS and PSQI scores than those in the control group. Repeated measures analysis of variance showed that the patients in the observation group had significantly better improvement in the anxiety level and sleep quality than the control patients (P < 0.05). The combined therapies also significantly reduced the SOL and increased TST and SE as compared with CBT-I only (P < 0.05). Conclusion Intervention with CBT-I alone has a poor effect on anxiety and an unstable effect on insomnia. The combination of CBT-I with hypnosis can achieve significant improvements in the anxiety level and sleep quality of the patients with long-lasting and stable effects.

Keywords

• hypnosis
• cognitive behavior therapy for insomnia
• insomnia
• anxiety
• treatment outcome