1086 CBT-I FOR MENOPAUSE RELATED INSOMNIA ALSO REDUCES DEPRESSION SEVERITY

Abstract

Introduction:Menopause has been associated with elevated risk of mood disturbances. This relationship has been attributed to a number of factors including alterations in hormone levels, psychosocial factors, and insomnia associated with menopause. While cognitive behavioral therapy for insomnia (CBT-I) has been shown to also reduce depression in the general population, the effectiveness of CBT-I in reducing depression associated with menopause has not been tested.Methods:122 females with insomnia concurrent with menopause were randomized into three conditions: CBT-I (N=41), Sleep Restriction Therapy (SRT, N=41) and an Information-only control condition (IC, N=40). Outcome measures included Insomnia Severity Index (ISI), and Beck Depression Inventory (BDI-II; sans sleep items). All measures were conducted pre-, post-treatments, and at 6 months follow-up.Results:dCBT-I resulted in a robust significant improvement in ISI (-8.2 ± 5.3 points) compared to control (-4.0 ± 4.2 points). The post-treatment remission rate (ISI≤10) was significantly greater in the dCBT-I condition (67.1%) compared to the control group (33.7%; p.01). Similar results were observed for depression symptoms, with the dCBT-I condition exhibiting decreased depression severity (-3.0 ± 4.1 points, from 7.2 ± 4.2 pre-treatment) compared to the control condition (-1.2 ± 3.2 points, from 7.1 ± 3.9 pre-treatment, p.01). Whereas depression rates (QIDS≥10) were comparable between conditions at pre-treatment (control: 28.3%; dCBT-I: 24.0%, p.05), the dCBT-I condition exhibited a significantly lower rate of clinically significant depression at post-treatment (8.2%) compared to the control group (19.0%, p.01). Results stratified by demographics indicated that dCBT-I yielded a near identical and significant decrease in both insomnia and depression symptom severity across all demographic groups.Conclusion:Findings from this study provide evidence for the effectiveness of CBT-I for insomnia associated with menopause, and also suggest its potential for reducing concurrent depression. Furthermore, gains in depression symptoms appear to be sustained up to 6 months following CBT-I, and may also continue to decrease over time.Support (If Any):This research is funded by the National Institute of Nursing Research (R01NR013959, PI:Drake).