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Sleepless in Sweden: a single subject study of effects of cognitive therapy for insomnia on three adolescents
Örebro University, School of Law, Psychology and Social Work. (Center for Health And Medical Psychology (CHAMP))
Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden. (Center for Health And Medical Psychology (CHAMP))
2011 (English)In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 39, 367-374 p.Article in journal (Refereed) Published
Abstract [en]

Background: Sleeping difficulties are an increasing problem for youths, but there is a lack of treatment research for this age group.

Aim: The aim of this study was to investigate the effects of Cognitive Therapy for Insomnia (CT-I) on youths with primary insomnia; this treatment has never been tested on youths before.

Method: The study was conducted according to an AB single-case experimental phase design, with pre-tests and post-tests. After 7–10 days of baseline assessment, three youths aged 16–18 (2 male) with primary insomnia participated in a 7-week long treatment. A sleep diary was used throughout the treatment. A followup assessment including one week with a sleep diary was conducted 3 months later. Visual inspection was used to analyze outcome.

Results: Insomnia severity was greatly reduced for all participants after treatment. Daily measures showed that sleep onset latency was reduced for two participants but no change in total sleep time was confirmed. Daytime symptoms fluctuated for the participants. The insomnia-specific psychological processes were reduced to varying extents. These results were maintained at the follow-up measure.

Conclusions: CT-I may be a promising treatment for youths with insomnia and the treatment should be tested further in randomized controlled studies.

Place, publisher, year, edition, pages
2011. Vol. 39, 367-374 p.
Keyword [en]
insomnia, cognitive therapy, single-case, adolescence
National Category
Applied Psychology
Research subject
URN: urn:nbn:se:oru:diva-32221DOI: 10.1017/S1352465810000664OAI: diva2:661255
Available from: 2013-11-01 Created: 2013-11-01 Last updated: 2014-08-25Bibliographically approved
In thesis
1. Cogito, ergo insomnis: I think, therefore I am sleepless
Open this publication in new window or tab >>Cogito, ergo insomnis: I think, therefore I am sleepless
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Insomnia is a common health complaint that often becomes a persistent problem. The theoretical frameworks for understanding and treating insomnia have mostly been behavioural, yet the importance of cognitive processes has received greater attention over the years. The overall aim of this dissertation was to expand the knowledge on the processes from the Cognitive Model of Insomnia by investigating them in novel contexts. Study I examined the outcomes from cognitive therapy for insomnia on adolescents. Study II explored the relationship between cognitive processes and the association with remission and persistence of insomnia in the general population. Lastly, Study III investigated if cognitive processes mediated between cognitive behavioural therapy for insomnia (CBT-I) and outcomes of insomnia and depressive severity in a sample of people with insomnia comorbid with depressive problems.

The findings show that cognitive therapy for insomnia affected sleep for adolescents, thus this is a promising treatment option for this age group. Further, it was found that cognitive processes distinguished between adults with normal sleep and persistent insomnia. For people with insomnia, elevated sleep-related worry at baseline increased the risk of reporting persistent insomnia later on, whereas a lowering of selective attention and monitoring, and safety behaviours over time increased the likelihood of remission from insomnia. This has clinical implications for insomnia assessment and treatment, as well as theoretical implications, and warrants further research. CBT-I was associated with greater reductions in dysfunctional beliefs and sleep-related safety behaviours compared to control treatment. Dysfunctional beliefs mediated between CBT-I and insomnia severity and depressive severity respectively. This supports the importance of negative thought content in both insomnia and depression.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2014. 96 p.
Örebro Studies in Psychology, ISSN 1651-1328 ; 30
insomnia, CBT, cognitive therapy, worry, dysfunctional beliefs, arousal, selective attention, safety behaviours
National Category
Research subject
urn:nbn:se:oru:diva-35794 (URN)978-91-7529-035-5 (ISBN)
Public defence
2014-10-03, Långhuset, Hörsal 2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:15 (Swedish)
Available from: 2014-07-24 Created: 2014-07-24 Last updated: 2015-12-28Bibliographically approved

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Norell Clarke, AnnikaJansson-Fröjmark, Markus
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