Efficacy of cognitive-behavioral therapy for insomnia: Implementation of a group format in the Spanish National Health System: Eficacia de la terapia cognitivo-conductual para el insomnio: Una aplicación grupal en el Sistema Nacional de Salud Español

Background. Cognitive-behavioral therapy for insomnia (CBT-i) is considered the first-line treatment for this disorder, but it is not widely implemented in clinical settings. This study aims to examine the efficacy of a CBT-i in group format in the Spanish National Health System. Method. Fifty-two participants with a Primary Insomnia Disorder (55.8% women; Mage = 47.19, SD = 11.02) were assigned to a CBT-i (n =17) or waiting list condition (n = 21). Treatment consisted of eight group format sessions (2 hours/week). Results. Significant improvements in insomnia severity, sleep quality, and insomnia-related dysfunctional beliefs and attitudes were observed in patients who received CBT-i. Emotional symptoms also decreased after the intervention in the CBT-i group. Conclusion. Findings support the efficacy of cognitive-behavioral therapy for insomnia with a group protocol for patients with primary insomnia disorder. The maintenance role of insomnia-related dysfunctional beliefs and attitudes in this disorder is also suggested.Abstract: Cognitive-behavioral therapy for insomnia (CBT-i) is considered the treatment of choice for this disorder, but it is not widely implemented in clinical settings. This study aims to examine the efficacy of a group format of CBT-i in the Spanish National Health System. Fifty-two participants with a primary insomnia disorder (55.8% women; Mage = 47.19, SD = 11.02) were assigned to a CBT-i (n =17) or waiting list condition (n = 21). Treatment consisted of eight group therapy sessions (2 hours/week). Significant improvements in insomnia severity, sleep quality, and insomnia-related dysfunctional beliefs and attitudes were observed in patients who received CBT-i. Emotional symptoms also decreased after the intervention in the CBT-i group. Findings support the efficacy of a group protocol of cognitive behavioral therapy for insomnia with a group protocol for patients with primary insomnia disorder. We also suggest a role of insomnia-related dysfunctional beliefs and attitudes in the maintenance of this disorder. Keywords: insomnia; cognitive-behavioral therapy for insomnia; sleep disorders; dysfunctional beliefs; emotional disorders. Eficacia de la terapia cognitivo-conductual para el insomnio: Una aplicación grupal en el Sistema Nacional de Salud Español Resumen: La terapia cognitivo-conductual para el insomnio (TCC-i) es considerada como el tratamiento de elección para este trastorno, aunque su implementación en contextos clínicos no está lo suficientemente extendida. Este estudio pretende examinar la eficacia de la TCC-i, en formato grupal, en el Sistema Nacional de Salud español. Cincuenta y dos participantes con un diagnóstico de Trastorno de Insomnio Primario (55.8% mujeres; Medad = 47.19, DT = 11.02) fueron asignados a la condición de TCC-i (n =17) o de lista de espera (n = 21). El tratamiento consistió en ocho sesiones grupales (2 horas/semana). Se observaron mejorías significativas en la gravedad del insomnio, la calidad de sueño y en las creencias y actitudes disfuncionales relacionadas con el insomnio, en aquellos pacientes que recibieron la TCC-i. Los síntomas emocionales también disminuyeron tras la intervención en el grupo de TCC-i. Los hallazgos apoyan la eficacia de la terapia cognitivo-conductual para el insomnio en un formato grupal para pacientes con trastorno de insomnio primario. Se sugiere el rol de las creencias y actitudes disfuncionales relacionadas con el insomnio en el mantenimiento de este trastorno. Palabras clave: insomnio; terapia cognitivo-conductual para el insomnio; trastornos del sueño; valoraciones disfuncionales; trastornos emocionales