Efficacy of cognitive behavioral therapy for insomnia comorbid to Parkinson's disease: A focus on psychological and daytime functioning with a single-case design with multiple baselines

J Clin Psychol. 2020 Mar;76(3):356-376. doi: 10.1002/jclp.22883. Epub 2019 Nov 20.

Abstract

Objective: To test the efficacy of cognitive behavioral therapy for insomnia (CBT-i) in Parkinson's Disease (PD) and to evaluate its impact on indices of daytime and psychological functioning.

Method: Fifteen patients with insomnia disorder (ID) comorbid to PD were enrolled in a single-case design with multiple baselines. Total wake time, sleep efficiency, and daytime sleepiness were recorded on a sleep diary. Self-reported measures of insomnia, anxiety and depressive symptoms, health-related quality of life, and psychological variables perpetuating ID were completed. All patients also underwent a clinical interview for ID diagnosis.

Results: CBT-i was associated with significant changes in sleep variables and ID criteria. Significant positive treatment-related effects were also noted for all indices of daytime and psychological functioning, and for variables perpetuating ID. All of these improvements were well maintained at 3-month follow-up.

Conclusion: CBT-i is a promising therapeutic avenue for patients with PD.

Keywords: Parkinson's disease; cognitive behavioral therapy; insomnia; non-motor symptoms; single-case design with multiple baselines.

MeSH terms

  • Adult
  • Aged
  • Anxiety / psychology
  • Cognitive Behavioral Therapy*
  • Comorbidity
  • Depression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / psychology*
  • Quality of Life
  • Self Report
  • Single-Case Studies as Topic
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Treatment Outcome