Table 2.
Randomised controlled trials of CBT-I with older patients in primary care
| Study | Sample size, n | Sex, % female | Mean age, years | Country/region | Intervention | Sessions, n | Session duration | Control condition | Intervention delivered by | Effect sizes, Cohen’s d | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOL | WASO | TST | SE | ISI | ||||||||||
| Buysse et al (2011)41 | 79 | 68.3 | 71.6 | US | Sleep restriction, SCT, sleep education; individual | 4 | 45–60 mins face to face; 20 mins telephone; 30 mins face to face; 20 mins telephone |
Education (articles), 10-mins telephone call | Mental health nurse practitioner | 3.38 | 3.91 | 1.83 | 3.43 | – |
| McCrae et al (2007)42 | 20 | 65.0 | 77.2 | US | Sleep restriction, SCT relaxation; individual | 4 | 2 × 50-min face to face; 2 × 30-mins telephone |
Sleep hygiene education | Mental health workers or social workers | 0.82 | 1.06 | 0.99 | 1.14 | – |
| Morgan et al (2012) 43a | 193 | 66.3 | 66.7 | UK | Self-help CBT-I booklets, HT info | 6 booklets | Weekly booklet | Sleep hygiene sheet | Booklet | – | – | – | b | 0.74 |
| Vitiello et al (2013) 44c (two of three study arms) | 245 | 77.6 | 73.1 | US | CBT for pain and insomnia; group | 6 | 90 mins | Education on pain + sleep management | Counsellor, psychologist | – | – | – | b | 0.40 |
a
Patients had long-term conditions.
b
Reported but not based on sleep diaries.
c
Patients had osteoarthritis. Dashes signify not reported. CBT-I = cognitive behavioural therapy for insomnia. HT = hypnotic medication tapering. ISI = Insomnia Severity Index. SCT = stimulus control therapy. SE = sleep efficiency. SOL = sleep onset latency. TST = total sleep time. WASO = wake after sleep onset.