Journals / Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / 2025 / Cilt: 11 Sayı: 3

The effect of cognitive behavioral therapy intervention on insomnia in individuals diagnosed with depression: A meta-analysis

Depresyon tanısı olan ve insomnia yaşayan bireylere uygulanan bilişsel davranışçı terapi müdahalesinin insomnia üzerine etkisi: Meta analiz

Tuğba Sarı(ATILIM ÜNİVERSİTESİ)0000-0002-5172-8662
Halil İbrahim Bilkay(KTO KARATAY ÜNİVERSİTESİ)0000-0002-8231-960X
Pages
295–308
Publication Date
2025-12-31
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: The findings indicate that CBT is an effective intervention for treating insomnia associated with depression.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: This meta-analysis aims to evaluate the effect of cognitive behavioral therapy on insomnia symptoms in individuals diagnosed with depression and experiencing insomnia.
📊
Key Findings & Data:Materials and Methods: Conducted in accordance with PRISMA guidelines, this study involved a systematic literature search across five databases between October 2024 and March 2025.
💡
Conclusion & Impact:Conclusion: The findings indicate that CBT is an effective intervention for treating insomnia associated with depression.
🔬Design:Modeling & Simulation
📍Scope:2024 Verileri
⚙️Variables:Bilişsel davranışçı terapi · Depresyon · İnsomnia

Abstract

Aim: This meta-analysis aims to evaluate the effect of cognitive behavioral therapy on insomnia symptoms in individuals diagnosed with depression and experiencing insomnia. Materials and Methods: Conducted in accordance with PRISMA guidelines, this study involved a systematic literature search across five databases between October 2024 and March 2025. Experimental-design studies implementing CBT interventions were included. Data were analyzed using Comprehensive Meta-Analysis v2 software, and effect sizes were calculated using Cohen’s d under a random-effects model. Results: Data from 2658 participants across 11 randomized controlled trials (RCTs) were analyzed. CBT was found to significantly reduce the severity of insomnia (SMD=-1.392; 95% CI:-1.562, -1.223; p<0.001). The effect size varied according to the intervention method, number of sessions, and country of origin. Conclusion: The findings indicate that CBT is an effective intervention for treating insomnia associated with depression.

Özet

Amaç: Bu meta-analiz, depresyon tanısı almış ve insomnia yaşayan bireylerde bilişsel davranışçı terapinin insomnia semptomlarına etkisini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: PRISMA yönergelerine uygun olarak yürütülen çalışmada, Ekim 2024-Mart 2025 arasında beş veri tabanında literatür taranmış, deneysel tasarımlı BDT müdahale çalışmaları dahil edilmiştir. Veriler Comprehensive Meta-Analysis v2 ile analiz edilerek Cohen’s d ile etki büyüklüğü hesaplanmış, rastgele etkiler modeli kullanılmıştır. Bulgular: Toplam 11 RCT çalışmasından elde edilen 2658 katılımcının verileri analiz edilmiş; BDT’nin insomnia şiddetini anlamlı düzeyde azalttığı görülmüştür (SMD =-1,392; %95 GA:-1,562, -1,223; p<0,001). Etki büyüklüğü müdahale yöntemi, seans sayısı ve ülkeye göre değişmiştir. Sonuç: Bulgular, BDT’nin depresyonla ilişkili insomnia tedavisinde etkili olduğunu göstermektedir.

🔖

Cite This Article

Sarı, T., Bilkay, H. İ. (2025). The effect of cognitive behavioral therapy intervention on insomnia in individuals diagnosed with depression: A meta-analysis. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 11 Sayı: 3, 295–308. https://doi.org/10.30569/adiyamansaglik.1687430

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (37)

  1. World Health Organization. (2025). “Depression.” https://www.who.int/health-topics/depression [Erişim Tarihi: 09.04.2025]
  2. Kolovos S, Kleiboer A, Cuijpers P. Effect of psychotherapy for depression on quality of life: meta-analysis. British Journal of Psychiatry. 2016; 209 (6): 460-468. https://doi.org/10.1192/bjp.bp.115.175059
  3. Geoffroy PA, Hoertel N, Etain B, et al. Insomnia and hypersomnia in major depressive episode: Prevalence, sociodemographic characteristics and psychiatric comorbidity in a population-based study. Journal of Affective Disorders. 2018; 226: 132-141. https://doi.org/10.1016/j.jad.2017.09.032
  4. Vargas I, Muench A, Seewald M, et al. 754 insomnia and depression symptoms in primary care patients referred for mental health care. Sleep. 2021; 44: A294. https://doi.org/10.1093/sleep/zsab072.751
  5. Vargas I, Perlis M. Insomnia and depression: clinical associations and possible mechanistic links. Curr Opin Psychol. 2019; 34: 95-99. https://doi.org/10.1016/j.copsyc.2019.11.004
  6. Zhang M, Du Y, Wang K, et al. Sleep disorders and non-sleep circadian disorders predict depression: A systematic review and meta-analysis of longitudinal studies. Neurosci Biobehav Rev. 2022; 134: 104532. https://doi.org/10.1016/j.neubiorev.2022.104532
  7. Blom K, Forsell E, Hellberg M, et al. Psychological treatment of comorbid insomnia and depression: A double-blind randomized placebo-controlled trial. Psychother Psychosom. 2024; 93 (2): 100-113. https://doi.org/10.1159/000536063
  8. Ohayon M, Cote M. 0323 Natural Evolution of Insomnia in Major Depressive Disorders. Sleep. 2023; 46 (1): A144. https://doi.org/10.1093/sleep/zsad077.0323
  9. Cheng P, Kalmbach DA, Tallent G, et al. Depression prevention via digital cognitive behavioral therapy for insomnia: a randomized controlled trial. Sleep. 2019; 42 (10): zsz150. https://doi.org/10.1093/sleep/zsz150
  10. Pigeon W, Bishop T, Bossarte R, et al. A two-phase, prescriptive comparative effectiveness study to optimize the treatment of co-occurring insomnia and depression with digital interventions. Contemp Clin Trials. 2023; 132: 107306. https://doi.org/10.1016/j.cct.2023.107306
  11. Cunningham JEA, Shapiro CM. Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. J Psychosom Res. 2018; 106: 1-12. https://doi.org/10.1016/j.jpsychores.2017.12.012
  12. Dyrberg H, Bjorvatn B, Larsen E. Cognitive Behavioral Therapy for Chronic Insomnia in Outpatients with Major Depression—A Randomised Controlled Trial. J Clin Med. 2022; 11 (19): 5845. https://doi.org/10.3390/jcm11195845
  13. Hertenstein E, Trinca E, Wunderlin M, et al. Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2022; 62: 101597. https://doi.org/10.1016/j.smrv.2022.101597
  14. Furukawa Y, Nagaoka D, Sato S, et al. Cognitive behavioral therapy for insomnia to treat major depressive disorder with comorbid insomnia: A systematic review and meta-analysis. J Affect Disord. 2024; 367: 359–366. https://doi.org/10.1016/j.jad.2024.09.017
  15. Morin CM. Cognitive-behavioral therapy of insomnia. Sleep Med Clin. 2006; 1 (3): 375–86. https://doi.org/10.1016/j.jsmc.2006.06.008
  16. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151 (4): 264-269.
  17. Puljak L, Ramic I, Naharro C, et al. Cochrane risk of bias tool was used inadequately in the majority of non-Cochrane systematic reviews. J Clin Epidemiol. 2020; 123: 114–9.
  18. The Joanna briggs ınstitute critical appraisal tools for use in IBI Systematic Reviews. http://joannabriggs.org/research/critical-appraisal-tools.html(25.03.2025).
  19. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Lawrence Erlbaum Associates; 1998.
  20. Chung KF, Lee CT, Au CH, et al. Cognitive behavioural therapy for insomnia as an early intervention of mood disorders with comorbid insomnia: A randomized controlled trial. Early Interv Psychiatry. 2024; 18 (2): 82-93. doi:10.1111/eip.13435
  21. Chan CS, Wong CYF, Yu BYM, et al. Treating depression with a smartphone-delivered self help cognitive behavioral therapy for insomnia: a parallel-group randomized controlled trial. Psychological Medicine. 2023; 53: 1799-1813. https://doi.org/10.1017/ S0033291721003421
  22. Glozier N, Christensen H, Griffiths KM, et al. Adjunctive Internet-delivered cognitive behavioural therapy for insomnia in men with depression: A randomised controlled trial. Aust N Z J Psychiatry. 2019; 53 (4): 350-360. doi: 10.1177/0004867418797432
  23. Batterham PJ, Christensen H, Mackinnon AJ, et al. Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression. BJPsych Open. 2017; 3 (5): 228-235. doi: 10.1192/bjpo.bp.117.005231.
  24. van der Zweerde T, van Straten A, Effting M, et al. Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms. Psychological Medicine. 2018; 49: 501-509. https:// doi.org/10.1017/S0033291718001149
  25. Leerssen J, Lakbila-Kamal O, Dekkers LMS, et al. Treating ınsomnia with high risk of depression using therapist-guided digital cognitive, behavioral, and circadian rhythm support ınterventions to prevent worsening of depressive symptoms: A randomized controlled trial. Psychother Psychosom. 2022; 91 (3): 168-179. doi: 10.1159/000520282.
  26. Pigeon WR, Funderburk J, Bishop TM, Crean HF. Brief cognitive behavioral therapy for insomnia delivered to depressed veterans receiving primary care services: A pilot study. J Affect Disord. 2017; 217: 105-111. doi: 10.1016/j.jad.2017.04.003
  27. Kyle SD, Hurry MED, Emsley R, et al. The effects of digital cognitive behavioral therapy for insomnia on cognitive function: a randomized controlled trial. Sleep. 2020; 43 (9): zsaa034. doi: 10.1093/sleep/zsaa034.
  28. Blom K, Jernelöv S, Kraepelien M, et al. Internet treatment addressing either insomnia or depression, for patients with both diagnoses: a randomized trial. Sleep. 2015; 38 (2): 267-277. doi: 10.5665/sleep.4412.
  29. Rajabi Majd N, Broström A, Ulander M, et al. Efficacy of a theory-based cognitive behavioral technique app-based ıntervention for patients with ınsomnia: Randomized controlled trial. J Med Internet Res. 2020; 22 (4): e15841. doi: 10.2196/15841
  30. Steinmetz L, Simon L, Feige B, et al. Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia. Clin Psychol Rev. 2024; 114: 102507. https://doi.org/10.1016/j.cpr.2024.102507
  31. Cheung JMY, Jarrin DC, Ballot O, et al. A systematic review of cognitive behavioral therapy for insomnia implemented in primary care and community settings. Sleep Med Rev. 2019; 44: 23–36. https://doi.org/10.1016/j.smrv.2018.11.001
  32. Bishop T, Crean H, Funderburk J, et al. 1087 Early Session Effects of CBT-I on Insomnia and Depression. Sleep. 2020; 43 (Suppl 1): zsaa056.1082. https://doi.org/10.1093/sleep/zsaa056.1082
  33. Bishop T, Crean H, Funderburk J, Pigeon W. Initial Session Effects of Brief Cognitive Behavioral Therapy for Insomnia: A Secondary Analysis of A Small Randomized Pilot Trial. Behav Sleep Med. 2021; 19: 769–82. https://doi.org/10.1080/15402002.2020.1862847
  34. Lau P, Starick E, Kumar K, Carney C. Comparing patients treated with CBT for insomnia with healthy sleepers and sleepers with past insomnia on dimensions of sleep health. Sleep Health. 2024. https://doi.org/10.1016/j.sleh.2024.03.005
  35. Ballesio A, Aquino M, Feige B, et al. The effectiveness of behavioural and cognitive behavioural therapies for insomnia on depressive and fatigue symptoms: A systematic review and network meta-analysis. Sleep Med Rev. 2018; 37: 114-129. https://doi.org/10.1016/j.smrv.2017.01.006
  36. Soh HL, Ho RC, Ho CS, Tam WW. Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials. Sleep Med. 2020; 75: 315-325. https://doi.org/10.1016/j.sleep.2020.08.020
  37. Biagianti B, Foti G, Di Liberto A, et al. CBT-informed psychological interventions for adult patients with anxiety and depression symptoms: A narrative review of digital treatment options. J Affect Disord. 2023; 325: 682-694. https://doi.org/10.1016/j.jad.2023.01.057