Cognitive-behavioral therapy of insomnia: A clinical case series study of patients with co-morbid disorders and using hypnotic medications

Diana C. Dolan, Daniel J. Taylor, Adam D. Bramoweth, Leon D. Rosenthal

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Cognitive-behavioral therapy for insomnia (CBTi) has demonstrated considerable efficacy within randomized clinical trials and case-series designs. This case-series study in a community sleep medicine clinic assessed the effectiveness of an eight-session CBTi protocol chronic insomnia patients who were allowed to continue their use of hypnotics (intent-to-treat n = 48), administered by a clinical psychology doctoral student receiving training and supervision in CBTi by a behavioral sleep medicine certified clinician. Outcome measures included daily sleep diaries, self-report measures on insomnia severity, dysfunctional beliefs and attitudes about sleep, daytime sleepiness, as well as medication usage. Patients showed significant improvements in sleep onset latency, wake time after sleep onset, sleep efficiency, insomnia severity, and dysfunctional sleep beliefs from pre- to post-treatment. No changes were seen in daytime sleepiness - patients were not excessively sleepy either before or after treatment. Use of sleep medication declined significantly from 87.5% pre-treatment to 54% post-treatment, despite no active efforts to encourage patients to withdraw. Results demonstrate that a CBTi conducted in a community sleep medicine clinic with patients not required to discontinue sleep-related medications can have similar effects as therapy delivered among those not on medication.

Original languageEnglish (US)
Pages (from-to)321-327
Number of pages7
JournalBehaviour Research and Therapy
Issue number4
StatePublished - Apr 2010
Externally publishedYes


  • Behavioral
  • CBTi
  • Cognitive
  • Insomnia
  • Sleep medicine
  • Therapy

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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