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Behav Sleep Med. 2017 Mar 23:1-16. doi: 10.1080/15402002.2017.1299737. [Epub ahead of print]

Modified Cognitive Behavioral Therapy for Insomnia in Depressed Adolescents: A Pilot Study.

Author information

1
a Department of Psychiatry , University of Michigan , Ann Arbor , Michigan.
2
b Pediatric Behavioral Development , University of Michigan , Ann Arbor , Michigan.
3
c Pediatric Sleep Medicine and Clinical Neurophysiology , University of Michigan , Ann Arbor , Michigan.

Abstract

OBJECTIVE/BACKGROUND:

The purpose of the study was to pilot a five-week insomnia treatment in adolescents with major depressive disorder (MDD) and insomnia. This was an open-label trial of a modified-group cognitive behavioral therapy for insomnia (CBTI).

PARTICIPANTS:

Adolescents with MDD (n = 16; mean age = 17.3 +/- 1.7), characterized by the Children's Depression Rating Scale-Revised T-score ≥ 55 and insomnia, characterized by > 30 min to fall or return to sleep and an Insomnia Severity Index (ISI) score of ≥ 7 participated.

METHODS:

Sleep diaries, actigraphy, weekly ISI, Quick Inventory of Depressive Symptomatology (QIDS), and Multidimensional Fatigue Inventory (MFI) were completed.

RESULTS:

Paired t-tests comparing pre- and posttreatment revealed a decrease in sleep onset latency from 41 min +/- 14 min to 18 min +/- 8.9 min (t = 5.9, p = .004). Linear mixed modeling across sessions revealed that ISI (B = 11.0, SE = 0.94, p < .001), QIDS (B = 11.3, SE = 0.96, p < .001), and MFI (B = 30.0, SE = 4.4, p < .001) improved across treatment. Daily sleep diaries showed decreased wake during the night (B = 22.8, SE = 7.19, p = .008), increased sleep time (B = 382.4, SE = 71.89, p < .001), and increased quality of sleep (B = 3.7, SE = 0.37, p < .001). When asked whether group members would recommend this group, 27% responded "yes" and 73% responded "definitely yes."

CONCLUSIONS:

Additional controlled studies utilizing sleep-focused therapy in depressed adolescents with insomnia are warranted.

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