The effectiveness of cognitive behavioural therapy for insomnia patients with co-morbid obstructive sleep apnea

Objectives: Although Cognitive Behavioural Therapy for insomnia (CBTi) is effective for patients with insomnia alone, the aim of the present study was to determine the effectiveness of CBTi for patients with co-morbid OSA. Methods: Sleep and daytime insomnia symptoms of 77 participants with insomnia and comorbid OSA were assessed at pre-treatment using 7-day sleep diaries and a battery of self-report questionnaires about daytime functioning and feelings. Participants were then randomly allocated to receive 4 weeks of CBTi or to a waitlist control, and were then re-assessed immediately following the4 weeks. Results: Compared to the waitlist group, the CBTi group showed significantly greater decrease of sleep onset latency (23.4 min vs.8.4 min), greater decrease of wake time after sleep onset (46 min vs.12.8 min) and greater increase of sleep efficiency (15.6% vs. 5.6%).In the questionnaires the treated group showed significantly greater decrease of insomnia severity index (6.2 vs 1.8), Flinders Fatigue Score (2.5 vs. 0.5), dysfunctional beliefs and attitudes about sleep-16score (10.8 vs. 0.5), and Stress score. Conclusions: The CBTi group showed greater improvements than the waitlist control group in all sleep diary and questionnaire measures with the majority of those improvements significantly greater in the CBTi group. These improvements were compared to a recent meta-analysis of randomized placebo controlled CBTi studies for insomnia without co-morbidities (Trauer et al. 2015). Overall it appears that there is little or no difference in the effectiveness of insomnia treatment in the presence or absence of co-morbid OSA. Disclosure: Nothing to disclose.