Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.47626/2237-6089-2024-0819
Trends in Psychiatry and Psychotherapy
Original Article

Cognitive Behavioural Therapy for insomnia decreases the discrepancy between objective and subjective measures of sleep

Lauren E. Cudney, Sheryl M. Green, Randi E. McCabe, Benicio N. Frey

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Abstract

Introduction
Individuals with insomnia disorder often exhibit differences between reported experiences of sleep and objectively measured sleep parameters; however, the implications of this subjective-objective sleep discrepancy during treatment remains unclear. 

Objective
The aim of this study was to investigate the impact of cognitive behavioural therapy for insomnia (CBT-I) on the discrepancy between objective and subjective measures of sleep, and to assess whether changes in clinical variables such as depression, anxiety, fatigue, and beliefs about sleep, were related to changes in discrepancy. 

Methods
Twenty-five participants with insomnia disorder were enrolled in group CBT-I. Sleep measures were continually sampled from baseline until 2 weeks post-treatment with both objective (i.e., actigraphy) and subjective (i.e., sleep diary) methods. 

Results
The subjective-objective discrepancy significantly decreased from baseline early on in treatment (following the second session) and were maintained at post-treatment for sleep onset latency, wake after sleep onset (WASO) and sleep efficiency (SE). Total sleep time (TST) discrepancy and misperception decreased from baseline to post-treatment. Improvement in depression symptoms, fatigue symptoms, and negative beliefs about sleep were significantly correlated with the decrease in the discrepancy for WASO and SE.

Conclusion
These findings suggest that CBT-I resolves the mismatch between objective and subjective sleep parameters early in treatment for adults with insomnia.  Sleep misperception improved from underestimating to accurately estimating TST. Improvement of psychological symptoms were related to decrease in sleep discrepancies across treatment. Future research is needed to explore how feedback on objective and subjective sleep discrepancy may impact sleep perception across treatment with CBT-I. 

Keywords

Insomnia, cognitive behavioural therapy for insomnia, actigraphy, subjective-objective sleep discrepancy

Submitted date:
03/01/2024

Accepted date:
06/27/2024

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