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Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects

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Title: Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects
Author(s): Kapella, Mary C.; Herdegen, James J.; Perlis, Michael L.; Shaver, Joan L.; Larson, Janet L.; Law, Julie A.; Carley, David W.
Subject(s): CBT-I emphysema chronic bronchitis sleep disturbance
Abstract: Background: Many people with COPD report difficulties falling asleep or staying asleep, insufficient sleep duration, or nonrestorative sleep. Cognitive behavioral therapy for insomnia (CBT-I) has proved effective not only in people with primary insomnia but also in people with insomnia comorbid with psychiatric and medical illness (eg, depression, cancer, and chronic pain). However, CBT-I has rarely been tested in those with COPD who have disease-related features that interfere with sleep and may lessen the effectiveness of such therapies. The purpose of this study was to determine the feasibility of applying a CBT-I intervention for people with COPD and to assess the impact of CBT-I on insomnia severity and sleep-related outcomes, fatigue, mood, and daytime functioning. Methods: The study had two phases. In Phase 1, a 6-weekly session CBT-I intervention protocol in participants with COPD was assessed to examine feasibility and acceptability. Phase 2 was a small trial utilizing a prospective two-group pre- and post-test design with random assignment to the six-session CBT-I or a six-session wellness education (WE) program to determine the effects of each intervention, with both interventions being provided by a nurse behavioral sleep medicine specialist. Results: Fourteen participants (five in Phase 1 and nine in Phase 2) completed six sessions of CBT-I and nine participants completed six sessions of WE. Participants indicated that both interventions were acceptable. Significant positive treatment-related effects of the CBT-I intervention were noted for insomnia severity (P = 0.000), global sleep quality (P = 0.002), wake after sleep onset (P = 0.03), sleep efficiency (P = 0.02), fatigue (P = 0.005), and beliefs and attitudes about sleep (P = 0.000). Significant positive effects were noted for depressed mood after WE (P = 0.005). Conclusion: Results suggest that using CBT-I in COPD is feasible and the outcomes compare favorably with those obtained in older adults with insomnia in the context of other chronic illnesses.
Issue Date: 2011
Publisher: Dove Medical Press
Citation Info: Kapella, M. C., Herdegen, J. J., Perlis, M. L., Shaver, J. L., Larson, J. L., Law, J. A., & Carley, D. W. 2011. Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects. International Journal of Chronic Obstructive Pulmonary Disease, 6: 625-635. http://dx.doi.org/10.2147/COPD.S24858
Type: Article
Description: © 2011 Dove Medical Press, originally published in the International Journal of Chronic Obstructive Pulmonary Disease. DOI: 10.2147/COPD.S24858
URI: http://hdl.handle.net/10027/8273
ISSN: 1176-9106
Sponsor: This research was funded by NIH KO1 NR010749, NIH/NNRR 5K30RR022271, and NIH/NINR 5 P30.
Date Available in INDIGO: 2012-04-29
 

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