Volume 6, Issue 1 (12-2020)                   hrjbaq 2020, 6(1): 29-41 | Back to browse issues page

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Talebi M. The Effect of Cognitive Behavioral Therapy for Insomnia on Sleep Quality in Patients with Insomnia and Obstructive Sleep Apnea. hrjbaq. 2020; 6 (1) :29-41
URL: http://hrjbaq.ir/article-1-461-en.html
Department of Psychology, Non-Profit Higher Education Institute, Babol, Mazandaran, Iran. , (maryam.talebi68@yahoo.com)
Abstract:   (832 Views)

Introduction: Due to the difficulty of treatment in patients with insomnia and obstructive sleep apnea, the present study sought to investigate the effect of cognitive-behavioral therapy on weekly changes in sleep parameters and drowsiness in patients with moderate and severe respiratory distress.
Materials and Methods: The research method was quasi-experimental with pre-test and post-test design with a control group. The statistical population of the study was 100 patients with sleep apnea and insomnia at the sleep clinic in Tehran who were selected by purposive sampling. Research tools include Epworth Drowsiness Scale, polysomnography, sleep diary recording, positive airflow pressure device, and cognitive-behavioral therapy for insomnia. A mixed linear model was used to analyze the data.
Results: Patients' daily drowsiness increased slightly in the first week and returned to pre-treatment levels in subsequent weeks. Patients also experienced a gradual improvement in sleep delay, the first wake-up call, improved sleep quality, bedtime, and drowsiness during the weeks of treatment.
Conclusion: Cognitive-behavioral therapy for insomnia in the presence of moderate to severe respiratory failure is a safe and effective treatment. However, it seems that patients should be closely monitored to increase daily drowsiness in the first weeks of treatment.

Author Contribution: All done by Maryam Talebi.
Conflict of Interest/Funding/Supports: No conflict of interest and funding supports.  
Ethical Considerations: All ethical concerns respected. Also, it was approved in ethical committee of Non-Profit Higher Education Institute, Babol, Mazandaran, Iran (code: 600761187).  
Applicable Remarks: To evaluating the efficiency of cognitive-behavioral therapy for insomnia in patients with obstructive apnea.  

Full-Text [PDF 1845 kb]   (155 Downloads)    
Type of Study: Research | Subject: Special
Received: 2020/08/27 | Revised: 2021/03/15 | Accepted: 2020/12/24 | ePublished ahead of print: 2021/01/17 | Published: 2021/02/20

1. Nair D, Zhang SX, Ramesh V, Hakim F, Kaushal N, Wang Y, et al. Sleep fragmentation induces cognitive deficits via nicotinamide adenine dinucleotide phosphate oxidase-dependent pathways in mouse. Am J Respir Crit Care Med. 2011;184(11):1305-12. DOI: 10.1164/rccm.201107-1173OC PMID: 21868506
2. Talebi M, Tabatabaye K, Vahedi E. Application of Cognitive-Behavioral Therapy in Obstructive Sleep Apnea: Comparison of Combined Treatment, and CPAP Therapy on Executive Functions of the Brain. Sleep and Hypnosis (Online). 2018;20(3):148-59.
3. Chen HM, Clark AP, Tsai LM, Chao YF. Self-reported sleep disturbance of patients with heart failure in Taiwan. Nurs Res. 2009;58(1):63-71. DOI: 10.1097/NNR.0b013e31818c3ea0 PMID: 19092556
4. Mousavi F, Tavabi A, Iran-Pour E, Tabatabaei R, Golestan B. Prevalence and associated factors of insomnia syndrome in the elderly residing in Kahrizak nursing home, Tehran, Iran. Iranian Journal of Public Health. 2012;41(1):96.
5. Chou E-L, Liang S-J, Hsieh P-F, Chang C-H, Wu H-C. Continuous positive airway pressure therapy improves stage 1 and stage 2 sleep nocturia in individuals with obstructive sleep apnea. Urological Science. 2015;26(2):S30. DOI: 10.1016/j.urols.2015.06.015
6. Kyle SD, Miller CB, Rogers Z, Siriwardena AN, Macmahon KM, Espie CA. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder. Sleep. 2014;37(2):229-37. DOI: 10.5665/sleep.3386 PMID: 24497651
7. Vakulin A, Catcheside PG, Baulk SD, Antic NA, Banks S, Dorrian J, et al. Individual variability and predictors of driving simulator impairment in patients with obstructive sleep apnea. J Clin Sleep Med. 2014;10(6):647-55. DOI: 10.5664/jcsm.3792 PMID: 24932145
8. Sweetman A, McEvoy RD, Smith S, Catcheside PG, Antic NA, Chai-Coetzer CL, et al. The effect of cognitive and behavioral therapy for insomnia on week-to-week changes in sleepiness and sleep parameters in patients with comorbid insomnia and sleep apnea: a randomized controlled trial. Sleep. 2020;43(7). DOI: 10.1093/sleep/zsaa002 PMID: 31927569
9. Maurer L, Espie C, Omlin X, Kyle S. 0385 Daytime Impairment during Sleep Restriction Therapy for Insomnia: Results from a Randomised-Controlled Trial. Sleep. 2019;42(Supplement_1):A156-A. DOI: 10.1093/sleep/zsz067.384
10. Sweetman A, Lack L, Catcheside PG, Antic NA, Smith S, Chai-Coetzer CL, et al. Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sleep. 2019;42(12). DOI: 10.1093/sleep/zsz178 PMID: 31403168
11. Lovato N, Lack L, Wright H, Kennaway DJ. Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults. Sleep. 2014;37(1):117-26. DOI: 10.5665/sleep.3320 PMID: 24470701
12. Miller CB, Espie CA, Epstein DR, Friedman L, Morin CM, Pigeon WR, et al. The evidence base of sleep restriction therapy for treating insomnia disorder. Sleep Med Rev. 2014;18(5):415-24. DOI: 10.1016/j.smrv.2014.01.006 PMID: 24629826
13. Kyle SD, Morgan K, Spiegelhalder K, Espie CA. No pain, no gain: an exploratory within-subjects mixed-methods evaluation of the patient experience of sleep restriction therapy (SRT) for insomnia. Sleep Med. 2011;12(8):735-47. DOI: 10.1016/j.sleep.2011.03.016 PMID: 21907616
14. Loucao-de-Amorim I, Bentes C, Peralta AR. Men and women with chronic insomnia disorder and OSAS: Different responses to CPAP. Sleep Sci. 2019;12(3):190-5. DOI: 10.5935/1984-0063.20190085 PMID: 31890095
15. McCrae C, Curtis A, Staud R, Berry R, Robinson M. 0393 Baseline Pain Severity as a Moderator of the Effect of CBTi on Sleep and Pain Outcomes in Patients with Fibromyalgia. Sleep. 2019;42(Supplement_1):A159-A60. DOI: 10.1093/sleep/zsz067.392
16. Richards KC, Gooneratne N, Dicicco B, Hanlon A, Moelter S, Onen F, et al. CPAP Adherence May Slow 1-Year Cognitive Decline in Older Adults with Mild Cognitive Impairment and Apnea. J Am Geriatr Soc. 2019;67(3):558-64. DOI: 10.1111/jgs.15758 PMID: 30724333
17. Walia HK, Thompson NR, Pascoe M, Faisal M, Moul DE, Katzan I, et al. Effect of Positive Airway Pressure Therapy on Drowsy Driving in a Large Clinic-Based Obstructive Sleep Apnea Cohort. J Clin Sleep Med. 2019;15(11):1613-20. DOI: 10.5664/jcsm.8024 PMID: 31739851
18. Bhat S, Gupta D, Akel O, Polos PG, DeBari VA, Akhtar S, et al. The relationships between improvements in daytime sleepiness, fatigue and depression and psychomotor vigilance task testing with CPAP use in patients with obstructive sleep apnea. Sleep Med. 2018;49:81-9. DOI: 10.1016/j.sleep.2018.06.012 PMID: 30093261
19. Wang Y, Ai L, Luo J, Li R, Chai Y, He X, et al. Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy. Patient Prefer Adherence. 2017;11:769-79. DOI: 10.2147/PPA.S128217 PMID: 28442894
20. Eckert DJ, Sweetman A. Impaired central control of sleep depth propensity as a common mechanism for excessive overnight wake time: implications for sleep apnea, insomnia and beyond. J Clin Sleep Med. 2020;16(3):341-3. DOI: 10.5664/jcsm.8268 PMID: 32003739
21. Economou NT, Ilias I, Velentza L, Papachatzakis Y, Zarogoulidis P, Kallianos A, et al. Sleepiness, fatigue, anxiety and depression in Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea - Overlap - Syndrome, before and after continuous positive airways pressure therapy. PLoS One. 2018;13(6):e0197342. DOI: 10.1371/journal.pone.0197342 PMID: 29889828
22. Ahmadi S, Chehri A, Goldaste N. Investigating the psychometric properties of the Euport drowsiness questionnaire in adolescents. Journal of Psychometrics. 2019;8(31).
23. Alter A, Mireles-Cabodevila E, Aboussouan LS. Patient-Ventilator Asynchronies during Polysomnography. Ann Am Thorac Soc. 2018;15(10):1229-33. DOI: 10.1513/AnnalsATS.201803-196CC PMID: 30272502
24. Tanno S, Tanigawa T, Saito I, Nishida W, Maruyama K, Eguchi E, et al. Sleep-related intermittent hypoxemia and glucose intolerance: a community-based study. Sleep Med. 2014;15(10):1212-8. DOI: 10.1016/j.sleep.2014.05.027 PMID: 25156748
25. Morin CM, Vallieres A, Guay B, Ivers H, Savard J, Merette C, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005-15. DOI: 10.1001/jama.2009.682 PMID: 19454639
26. Pattinson CL, Guedes VA, Edwards K, Mithani S, Yun S, Taylor P, et al. Excessive daytime sleepiness is associated with altered gene expression in military personnel and veterans with posttraumatic stress disorder: an RNA sequencing study. Sleep. 2020;43(9). DOI: 10.1093/sleep/zsaa036 PMID: 32191323

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