Treatment of Comorbid Insomnia and Anxiety

Insomnia and anxiety are highly prevalent and are frequently comorbid. A new study compared whether internet cognitive behavioral therapy for insomnia (CBT-I) or internet cognitive behavioral therapy (CBT) for anxiety leads to the best outcomes in individuals with comorbid insomnia and anxiety.

120 participants with comorbid insomnia and anxiety were randomized to receive internet-based CBT-I or internet-based CBT for anxiety. The primary outcome measures were insomnia severity and a generalized anxiety disorder scale. Primary outcome measures were assessed before treatment, at mid-treatment, at post-treatment, and 3 months after treatment.

 Participants in both groups experienced large reductions in symptoms of insomnia and anxiety that were maintained at follow-up. However, at the end of treatment and at 3-month follow-up, CBT-I was more effective in reducing symptoms of insomnia than CBT for anxiety, and CBT-I was as effective as CBT for anxiety in reducing symptoms of anxiety.

 These results suggest that, in patients with comorbid insomnia and anxiety, CBT-I is the most effective treatment strategy.