0537 “Single-Shot” Cognitive Behavioral Therapy for Insomnia (CBT-I) Is Related to Improvements in Sleep Onset and Maintenance Problems

Abstract Introduction Although more than half of primary care patients endorse insomnia symptoms, few options are available to manage their sleep continuity disturbance. CBT-I is the first line treatment for insomnia, but a standard course of at least 6 sessions is typically not feasible in primary care settings. The present RCT investigated a “single shot” version of CBT-I in primary care patients suffering from clinically elevated insomnia symptoms. Methods Forty-one primary care patients (Mage = 26.2, SDage = 9.4; 70.7% women, 73.2% White) at an integrated behavioral health center were enrolled in the current study and randomly assigned to either one session of CBT-I or one session of an attentional control condition. Daily sleep diaries were used to assess changes in total wake time (TWT = SL+WASO+EMA) and sleep efficiency (%SE) at (1) baseline, (2) one-week post-treatment, and (3) one-month post-treatment. Insomnia symptoms (ISI) and depression symptoms (PHQ-8) were also assessed at baseline and one-month post-treatment. Results The final analyses included data from 37 patients (CBT-I = 17, control = 20), after 4 patients were lost to follow-up. Compared to the control group, patients who received one-session of CBT-I reported greater improvements in TWT (t(33) = -2.54, p<.01; mean difference = -42.64; Cohen’s d = -0.86) and %SE (t(33) = 1.80, p<.05; mean difference = 0.05; Cohen’s d=0.61) from baseline to post-treatment. The CBT-I patients continued to show greater improvements through the 1-month follow-up in TWT (t(30) = -4.11, p <.001; mean difference = -73.28; Cohen’s d = -1.46) and %SE (t(30) = 3.18, p<.01; mean difference = 0.12; Cohen’s d = 1.13). There was also greater improvement for patients in the CBT-I group on ISI scores (t(30) = -1.85, p<.05; mean difference = -2.65; Cohen’s d = -0.66) and PHQ-8 scores (t(29) = -2.29, p<.05; mean difference = -3.70; Cohen’s d = -0.83) from baseline to 1 month follow-up. Conclusion The present study provides preliminary data to support the use of “single-shot” CBT-I in primary care settings. Furthermore, results suggest that this one-session version of CBT-I may provide a potential benefit beyond sleep by also having meaningful effects on depression symptoms. Support (if any) K23-HL141581