Randomized controlled trial of an integrated approach to treating insomnia and improving the use of positive airway pressure therapy in veterans with comorbid insomnia disorder and obstructive sleep apnea

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dc.contributor.authorAlessi, Cathy A.
dc.contributor.authorFung, Constance H.
dc.contributor.authorDzierzewski, Joseph M.
dc.contributor.authorFiorentino, Lavinia
dc.contributor.authorStepnowsky, Carl
dc.contributor.authorTapia, Juan C. Rodriguez
dc.contributor.authorSong, Yeonsu
dc.contributor.authorZeidler, Michelle R.
dc.contributor.authorJosephson, Karen
dc.contributor.authorMitchell, Michael N.
dc.contributor.authorJouldjian, Stella
dc.contributor.authorMartin, Jennifer L.
dc.date.accessioned2025-01-20T23:51:48Z
dc.date.available2025-01-20T23:51:48Z
dc.date.issued2021
dc.description.abstractStudy Objectives: Cognitive behavioral therapy for insomnia (CBTI) for comorbid insomnia and obstructive sleep apnea (OSA) has had mixed results. We integrated CBTI with a positive airway pressure (PAP) adherence program and tested effects on sleep and PAP use.
dc.description.abstractMethods: 125 veterans (mean age 63.2, 96% men, 39% non-Hispanic white, 26% black/African American, 18% Hispanic/Latino) with comorbid insomnia and newly-diagnosed OSA (apnea-hypopnea index a 15) were randomized to 5-weekly sessions integrating CBTI with a PAP adherence program provided by a "sleep coach" (with behavioral sleep medicine supervision), or 5-weekly sleep education control sessions. Participants and assessment staff were blinded to group assignment. Outcomes (baseline, 3 and 6 months) included Pittsburgh Sleep Quality Index (PSQI), 7-day sleep diary (sleep onset latency [SOL-D], wake after sleep onset [WASO-D], sleep efficiency [SE-D]), 7-day actigraphy (SE-A), and objective PAP use (hours/night and nights 4 h). Insomnia Severity Index (151), Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10) were also collected.
dc.description.abstractResults: Compared to controls, intervention participants showed greater improvement (baseline to 3 and 6 months, respectively) in PSQI (-3.2 and -1.7), SOL-D (-16.2 and -15.5 minutes), SE-D (10.5% and 8.5%), SE-A (4.4% and 2.6%) and more 90-day PAP use (1.3 and 0.9 more hours/ night, 17.4 and 11.3 more nights PAP >= 4 h). 90-day PAP use at 3 months was 3.2 and 1.9 h/night in intervention versus controls. Intervention participants also had greater improvements in ISI, ESS, and FOSQ-10 (all p < 0.05).
dc.description.abstractConclusions: An intervention integrating CBTI with a PAP adherence program delivered by a supervised sleep coach improved sleep and PAP use in adults with comorbid insomnia and OSA.
dc.fuente.origenWOS
dc.identifier.doi10.1093/sleep/zsaa235
dc.identifier.eissn1550-9109
dc.identifier.issn0161-8105
dc.identifier.urihttps://doi.org/10.1093/sleep/zsaa235
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94859
dc.identifier.wosidWOS:000838816400028
dc.issue.numero4
dc.language.isoen
dc.revistaSleep
dc.rightsacceso restringido
dc.subjectinsomnia
dc.subjectsleep apnea
dc.subjectcognitive behavioral therapy
dc.subjectrandomized controlled trial
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRandomized controlled trial of an integrated approach to treating insomnia and improving the use of positive airway pressure therapy in veterans with comorbid insomnia disorder and obstructive sleep apnea
dc.typeartículo
dc.volumen44
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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