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Meta-Analysis
. 2015 Feb:19:6-16.
doi: 10.1016/j.smrv.2014.05.001. Epub 2014 May 14.

A meta-analysis of group cognitive behavioral therapy for insomnia

Erin A Koffel  1 , Jonathan B Koffel  2 , Philip R Gehrman  3
Affiliations
Meta-Analysis

A meta-analysis of group cognitive behavioral therapy for insomnia

Erin A Koffel et al. Sleep Med Rev. 2015 Feb.

Abstract

Insomnia is the most common sleep disorder among the general population. Although cognitive behavioral therapy for insomnia (CBT-I) is the psychological treatment of choice, the availability of individual therapy is often not sufficient to meet the demand for treatment. Group treatment can increase the efficiency of delivery, but its efficacy has not been well-established. Randomized controlled trials (RCTs) comparing group CBT-I to a control group in patients with insomnia were identified. A review of 670 unique citations resulted in eight studies that met criteria for analysis. Outcome variables included both qualitative (e.g., sleep quality) and quantitative (e.g., sleep diary) outcomes, as well as depression and pain severity, at both pre- to post-treatment and follow-up (3-12 mo post-treatment). Overall, we found medium to large effect sizes for sleep onset latency, sleep efficiency, and wake after sleep onset and small effect sizes for pain outcomes. Effect sizes remained significant at follow-up, suggesting that treatment gains persist over time. Other variables, including total sleep time, sleep quality, and depression, showed significant improvements, but these findings were limited to the within treatment group analyses. It is clear that group CBT-I is an efficacious treatment. Implications for stepped care models for insomnia are discussed.

Keywords: CBT-I; Group therapy; Insomnia.

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Figures

Figure 1
Figure 1
Flowchart showing the process of selecting studies included in the review.
Figure 2
Figure 2
Post-treatment effect size statistics for sleep efficiency. Individual study effect sizes are unweighted. Total value is based on the random effects model.
Figure 3
Figure 3
Post-treatment effect size statistics for sleep quality. Individual study effect sizes are unweighted. Total value is based on the random effects model.
Figure 4
Figure 4
Post-treatment effect size statistics for depression. Individual study effect sizes are unweighted. Total value is based on the random effects model.
Figure 5
Figure 5
Post-treatment effect size statistics for pain. Individual study effect sizes are unweighted. Total value is based on the random effects model.
See this image and copyright information in PMC

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