CBT Identified as Effective First-Line Treatment for Insomnia in AUD Patients
Cognitive behavioral therapy (CBT) has been identified as an effective first-line treatment for insomnia among individuals with alcohol use disorder, regardless of abstinence from alcohol.
The study, led by a University of Missouri School of Medicine researcher and published in JAMA Psychiatry, is the first to document that treating insomnia with CBT reduces the negative outcomes associated with excessive drinking.
Conducted in collaboration with the Harry S. Truman Veterans Affairs hospital in Columbia, Missouri, the study included 67 veterans in a VA addiction program who participated in a randomized clinical trial. Study participants met criteria for both alcohol use disorder (AUD) and insomnia. The participants were randomly assigned to 5 weekly sessions of CBT or a single session of sleep hygiene treatment, which involved a therapist recommending changes to bedtime routines, including limiting caffeine intake. CBT sessions educated participants on how insomnia develops, factors that maintain symptoms, and how to avoid insomnia moving forward.
Comparing the results of the interventions used, the study found that CBT outperformed sleep hygiene in reducing patients’ insomnia severity. CBT patients also had reduced alcohol use, fewer cravings, and fewer negative behaviors associated with alcohol consumption overtime. The findings were significant, researchers said, because they run counter to current recommendations to postpone CBT insomnia treatment until patients have achieved alcohol abstinence for at least 4 weeks.
“The typical standard of care is to wait to provide CBT for insomnia to patients with alcohol use disorder until they are abstinent from alcohol for 4 weeks,” study lead researcher Mary Beth Miller, PhD, University of Missouri assistant professor of psychiatry, said in a news release. “We wanted to see if CBT could improve insomnia symptoms and reduce alcohol-related harm before abstinence from alcohol use was established.
“CBT not only reduced insomnia symptoms among adults in early alcohol recovery—it also reduced the problems they experienced from drinking. We shouldn’t wait until people are abstinent to provide evidence-based treatment. We should give them the treatment they need when they’re open to it.”
The findings follow a previous study led by Dr Miller in 2020, which found that CBT is an effective intervention for reducing insomnia symptoms among young adults who had reported recent binge drinking episodes.
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