Effects of Cognitive Behavioral Therapy for Insomnia on Suicidal Ideation in Veterans

A new study is the first to show that the treatment of insomnia in veterans is associated with a significant reduction in suicidal ideation.

Results show that suicidal ideation decreased by 33 percent following up to six sessions of cognitive behavioral therapy for insomnia (CBT-I). Further analysis found that the reduction in insomnia severity achieved during CBT-I was associated with a concurrent decrease in the odds of suicidal ideation. This relationship remained significant after controlling for potential confounders such as change in depression severity.

In addition to improving insomnia and reducing suicidal thoughts, CBT-I led to improvements in depression and quality of life, which suggests that focusing greater attention on detecting and treating insomnia could produce substantial public health benefits.

The evaluation included a total of 405 veterans with diagnosed insomnia disorder who received CBT-I in routine primary care and mental health treatment settings. The majority of participants were men, and the mean patient age was 52 years. About 83 percent of veterans reported conflict experience, including 150 who served in Vietnam and 83 who served in Iraq or Afghanistan as part of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. Patients received CBT-I from therapists newly-trained in the therapy as part of the national dissemination of CBT-I in the U.S. Department of Veterans Affairs health care system. According to co-lead author Bradley Karlin, CBT-I’s effectiveness and feasibility for implementation suggest that there is considerable opportunity for broad dissemination of CBT-I in other health care systems.

Population of focus: Veterans

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Date: 2015

Journal: Sleep