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Feasibility of group cognitive behavioural therapy for insomnia (CBT-I) in bipolar disorder

Published online by Cambridge University Press:  13 August 2021

O. Swagemakers*
Affiliation:
Research Department, GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands
A. Nugter
Affiliation:
Research Department, GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands
F. Engelsbel
Affiliation:
Research Department, GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands
P. Schulte
Affiliation:
Research Department, GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands
*
*Corresponding author.

Abstract

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Introduction

Euthymic patients with bipolar I and II disorder (BD) often have comorbid insomnia, which is associated with worse outcome. Cognitive behavioral therapy for insomnia (CBT-I) is rarely offered to this population, though preliminary research indicates CBT-I to be safe and helpful to improve sleep and mood stability.

Objectives

The present study investigates if CBT-I for euthymic BD patients is feasible and acceptable when offered in a group format.

Methods

14 euthymic bipolar disorder I or II participants participated in a 7-session group CBT-I with BD-specific modifications (CBT-I-BD), preceded by one individual session. Feasibility and acceptability were assessed by recruitment, treatment drop-out and participants’ and therapists’ evaluations, while sleep quality, mood and sleep medication were assessed at baseline, end of treatment, 3 and 6 months later.

Results

31 of 539 patients with bipolar disorder were referred, 14 were included and one dropped out of treatment. Group CBT-I-BD was acceptable as shown by high session attendance and good homework compliance. Participants highly appreciated the treatment, the group format and learning effect. Insomnia severity decreased significantly between baseline and post-treatment. Group CBT-I-BD did not cause mood episodes during treatment and although not requested, the total number of nights with sleep medication decreased.

Conclusions

Group CBT-I-BD seems to be a feasible, acceptable and therefore viable treatment for euthymic patients with bipolar disorder suffering from persistent insomnia. The small sample size, resulting in small CBT-I-BD groups was a main limitation of the study.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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