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. 2014 Jul 15;9(7):e102565.
doi: 10.1371/journal.pone.0102565. eCollection 2014.

Reducing dysfunctional beliefs about sleep does not significantly improve insomnia in cognitive behavioral therapy

Isa Okajima  1 , Shun Nakajima  1 , Moeko Ochi  1 , Yuichi Inoue  1
Affiliations

Reducing dysfunctional beliefs about sleep does not significantly improve insomnia in cognitive behavioral therapy

Isa Okajima et al. PLoS One. .

Abstract

The present study examined to examine whether improvement of insomnia is mediated by a reduction in sleep-related dysfunctional beliefs through cognitive behavioral therapy for insomnia. In total, 64 patients with chronic insomnia received cognitive behavioral therapy for insomnia consisting of 6 biweekly individual treatment sessions of 50 minutes in length. Participants were asked to complete the Athens Insomnia Scale and the Dysfunctional Beliefs and Attitudes about Sleep scale both at the baseline and at the end of treatment. The results showed that although cognitive behavioral therapy for insomnia greatly reduced individuals' scores on both scales, the decrease in dysfunctional beliefs and attitudes about sleep with treatment did not seem to mediate improvement in insomnia. The findings suggest that sleep-related dysfunctional beliefs endorsed by patients with chronic insomnia may be attenuated by cognitive behavioral therapy for insomnia, but changes in such beliefs are not likely to play a crucial role in reducing the severity of insomnia.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Two alternate path models.
Figure 1 . Two alternative path models, with severity of insomnia at baseline as the predictive variable of severity (of insomnia) at the end of treatment: a direct model, in which AIS-T1 has a direct effect on AIS-T2; and a mediated model, in which the effects of AIS-T1 on AIS-T2 are exerted via a change in dysfunctional sleep-related beliefs. Standardized regression coefficients (β) are listed for each path. The paths expressed with solid arrows are statistically significant (p<0.01), and those expressed with dashed arrows are not significant. AIS-T1 = Athens Insomnia Scale scores at baseline; AIS-T2 = Athens Insomnia Scale scores at the end of the treatment.
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