Therapy for insomnia with chronic obstructive pulmonary disease: a randomized trial of componentsopen access
- Authors
- Kapella, Mary; Steffen, Alana; Prasad, Bharati; Laghi, Franco; Vispute, Sachin; Kemner, Gretchen; Teixeira, Celso; Peters, Tara; Jun, Jeehye; Law, Julie; Carley, David
- Issue Date
- Dec-2022
- Publisher
- AMER ACAD SLEEP MEDICINE
- Keywords
- cognitive behavioral therapy; sleep; insomnia; fatigue; dyspnea; chronic obstructive pulmonary disease
- Citation
- JOURNAL OF CLINICAL SLEEP MEDICINE, v.18, no.12, pp 2763 - 2774
- Pages
- 12
- Journal Title
- JOURNAL OF CLINICAL SLEEP MEDICINE
- Volume
- 18
- Number
- 12
- Start Page
- 2763
- End Page
- 2774
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/72317
- DOI
- 10.5664/jcsm.10210
- ISSN
- 1550-9389
1550-9397
- Abstract
- Study Objectives: To determine efficacy and mechanisms of cognitive behavioral therapy for insomnia (CBT-I) and chronic obstructive pulmonary disease (COPD) education (COPD-ED) on clinical outcomes in adults with concurrent COPD and insomnia.Methods: We conducted a 2 3 2 factorial study to test the impact of CBT-I and COPD-ED delivered alone or in combination on severity of insomnia and fatigue, sleep, and dyspnea. Participants were randomized to 1 of 4 groups-group 1: CBT-I + attention control (AC; health videos, n = 27); group 2: COPD-ED + AC, n = 28; group 3: CBT-I + COPD-ED, n = 27; and group 4, AC only, n = 27. Participants received six 75-minute weekly sessions. Dependent variables included insomnia severity, sleep by actigraphy, fatigue, and dyspnea measured at baseline, immediately postintervention, and at 3 months postintervention. Presumed mediators of intervention effects included beliefs and attitudes about sleep, self-efficacy for sleep and COPD, and emotional function.Results: COPD patients (percent predicted forced expiratory volume in 1 second [FEV1pp] 67% & PLUSMN; 24% [mean & PLUSMN; standard deviation]), aged 65 & PLUSMN; 8 years, with insomnia participated in the study. Insomnia and sleep improved more in patients who received CBT-I than in those who did not, an effect that was sustained at 3 months postintervention and mediated by beliefs and attitudes about sleep. CBT-I was associated with clinically important improvements in fatigue and dyspnea. When CBT-I and COPD-ED were concurrently administered, effects on insomnia, fatigue, and dyspnea were attenuated.Conclusions: CBT-I produced significant and sustained decreases in insomnia improved sleep and clinically important improvement in fatigue, and dyspnea. The combination of CBT-I and COPD-ED reduced CBT-I's effectiveness. Further research is needed to understand the mechanisms associated with effects of insomnia therapy on multiple symptoms in COPD.
- Files in This Item
-
- Appears in
Collections - Red Cross College of Nursing > Department of Nursing > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/72317)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.