4.5 Review

Insomnia disorder: State of the science and challenges for the future

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Article Psychiatry

Treating Insomnia with High Risk of Depression Using Therapist-Guided Digital Cognitive, Behavioral, and Circadian Rhythm Support Interventions to Prevent Worsening of Depressive Symptoms: A Randomized Controlled Trial

Jeanne Leerssen et al.

Summary: The study shows that therapist-guided cognitive behavioral therapy for insomnia (CBT-I) and circadian rhythm support (CRS) are effective in preventing the worsening of depressive symptoms in high-risk individuals with insomnia, with the combination of CBT-I+CRS being the most effective. Treatment adherence was higher with therapist-guided interventions compared to previous automated interventions.

PSYCHOTHERAPY AND PSYCHOSOMATICS (2022)

Review Clinical Neurology

Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis

Elisabeth Hertenstein et al.

Summary: This meta-analysis aimed to evaluate the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in patients with mental disorders and comorbid insomnia. The results showed that CBT-I had significant and lasting effects on insomnia severity and mental health in patients with depression, PTSD, and alcohol dependency.

SLEEP MEDICINE REVIEWS (2022)

Review Clinical Neurology

Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis

Faizul Hasan et al.

Summary: A network meta-analysis of digital cognitive behavioral therapy for insomnia in adults found that web-based CBTi combined with a therapist significantly improves sleep duration, sleep onset latency, wake after sleep onset, and sleep efficiency compared to usual care. The analysis suggests that this treatment is most likely to be ranked the highest among all treatments, indicating that it is the optimal intervention for improving sleep outcomes.

SLEEP MEDICINE REVIEWS (2022)

Article Psychiatry

Prevention of Incident and Recurrent Major Depression in Older Adults With Insomnia A Randomized Clinical Trial

Michael R. Irwin et al.

Summary: The study found that cognitive behavioral therapy for insomnia (CBT-I) has an overall benefit in preventing incident and recurrent major depression in older adults with insomnia disorder.

JAMA PSYCHIATRY (2022)

Article Clinical Neurology

Large-scale implementation of insomnia treatment in routine psychiatric care: patient characteristics and insomnia-depression comorbidity

Martin Kraepelien et al.

Summary: This study aimed to compare comorbidity and patient characteristics before and after the implementation of CBT-I for patients receiving treatment for depression. While pretreatment symptom levels were high, there were no significant changes in insomnia severity or comorbid diagnosis after CBT-I implementation. Contrary to expectations, comorbid depression levels among insomnia patients having CBT-I remained similar to previous studies.

JOURNAL OF SLEEP RESEARCH (2022)

Article Clinical Neurology

The effect of sleep restriction therapy for insomnia on sleep pressure and arousal: a randomized controlled mechanistic trial

Leonie F. Maurer et al.

Summary: The study aimed to investigate the mechanisms of action of sleep restriction therapy (SRT) on sleep pressure and arousal. The results showed that SRT increased sleep pressure and decreased arousal during acute implementation, providing support for its mechanism of action.
Review Clinical Neurology

HPA axis activity in patients with chronic insomnia: A systematic review and meta of case-control studies

Raphael J. Dressle et al.

Summary: This study aimed to evaluate the differences in cortisol levels, the hormonal end product of the HPA axis, between patients with insomnia and good sleeper controls. The results suggested that patients with insomnia showed moderately increased cortisol levels, with higher effect sizes found when analyzing studies that used blood samples. There was a positive but insignificant association between the extent of objective sleep loss in insomnia patients and group differences in cortisol levels.

SLEEP MEDICINE REVIEWS (2022)

Article Psychology, Developmental

Associations of sleep with psychological problems and well-being in adolescence: causality or common genetic predispositions?

Marije C. M. Vermeulen et al.

Summary: Short and problematic sleep are associated with worse psychological functioning in adolescents, and there are bidirectional associations between sleep and psychological problems. Changes in sleep problems in one individual of an identical twin pair are linked to increases in internalizing and externalizing problems, highlighting the importance of focusing on sleep quality for prevention and intervention.

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY (2021)

Review Physiology

BRAINMECHANISMS OF INSOMNIA: NEW PERSPECTIVES ON CAUSES AND CONSEQUENCES

Eus J. W. Van Someren

Summary: Insomnia is the second most common mental disorder, yet progress in understanding its underlying neurobiological mechanisms has been limited. This review explores the definition, prevalence, and susceptibility factors of insomnia, including genetic variants, early life stress, major life events, and brain structure and function. The proposed model suggests that in individuals vulnerable to developing insomnia, the locus coeruleus may be more sensitive to salience network input, leading to a spiral of hyperarousal and impaired sleep.

PHYSIOLOGICAL REVIEWS (2021)

Article Psychology, Clinical

A Randomized Controlled Trial of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) to Improve Serious Mental Illness Outcomes in a Community Setting

Allison G. Harvey et al.

Summary: The study showed that TranS-C intervention significantly improved patients' functional impairment, psychiatric symptoms, and sleep and circadian functioning, with effects maintained in the long-term follow-up. This treatment also had positive effects on improving sleep efficiency, reducing wake time, and enhancing sleep health composite score.

JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY (2021)

Article Psychology, Clinical

Does adjunctive digital CBT for insomnia improve clinical outcomes in an improving access to psychological therapies service?

Richard Stott et al.

Summary: Insomnia, often neglected in mental health programmes, has been shown to have a strong connection with anxiety and depression. A digital sleep intervention based on CBT-I principles, Sleepio, was introduced alongside other mental health interventions, resulting in significant clinical benefits and improved outcomes. This approach offers a feasible and highly scalable model for enhancing mental health outcomes in clinical services.

BEHAVIOUR RESEARCH AND THERAPY (2021)

Article Clinical Neurology

Insomnia as a mediating therapeutic target for depressive symptoms: A sub-analysis of participant data from two large randomized controlled trials of a digital sleep intervention

Alasdair L. Henry et al.

Summary: Insomnia and depression are closely related, and cognitive behavioral therapy can help improve both conditions. Digital cognitive behavioral therapy has significant effects on insomnia and depressive symptoms, showing promise as a treatment option for individuals with clinically significant depressive symptoms.

JOURNAL OF SLEEP RESEARCH (2021)

Article Biochemistry & Molecular Biology

Conscious experiences and high-density EEG patterns predicting subjective sleep depth

Aurelie M. Stephan et al.

Summary: This study challenges the traditional notion that slow wave sleep accounts for feeling deeply asleep, revealing that subjective sleep depth is related to a neurophysiological process predominating in early NREM sleep, particularly in REM sleep. Brain activity in sleep misperceptors is more frequent and widespread, providing insights into improving subjective sleep quality research.

CURRENT BIOLOGY (2021)

Article Clinical Neurology

The acute effects of sleep restriction therapy for insomnia on circadian timing and vigilance

Leonie F. Maurer et al.

Summary: Sleep-restriction therapy (SRT) has been shown to improve insomnia symptoms by restricting sleep opportunity and delaying the timing of sleep attempt, leading to an increase in phase angle. Additionally, SRT has effects on psychomotor vigilance, delaying reaction time and increasing the number of lapses.

JOURNAL OF SLEEP RESEARCH (2021)

Review Clinical Neurology

Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment

Jack D. Edinger et al.

Summary: This systematic review provides evidence on behavioral and psychological treatments for chronic insomnia disorder in adults, evaluating the clinical effects and impacts on patients.

JOURNAL OF CLINICAL SLEEP MEDICINE (2021)

Article Clinical Neurology

Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline

Jack D. Edinger et al.

Summary: This guideline provides clinical practice recommendations for the use of behavioral and psychological treatments for chronic insomnia disorder in adults. It includes recommendations for using multicomponent cognitive behavioral therapy and various brief therapies in the treatment of chronic insomnia disorder.

JOURNAL OF CLINICAL SLEEP MEDICINE (2021)

Review Clinical Neurology

The effects of non-invasive brain stimulation on sleep disturbances among different neurological and neuropsychiatric conditions: A systematic review

Alberto Herrero Babiloni et al.

Summary: Sleep disturbances and poor sleep quality are major health concerns in various neurological and neuropsychiatric clinical conditions. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have the potential to improve insomnia symptoms and sleep disturbances across different types of diseases, although more research is needed to reduce bias and optimize brain stimulation parameters.

SLEEP MEDICINE REVIEWS (2021)

Article Multidisciplinary Sciences

Insomnia subtypes characterised by objective sleep duration and NREM spectral power and the effect of acute sleep restriction: an exploratory analysis

Chien-Hui Kao et al.

Summary: Insomnia disorder is a heterogeneous condition with proposed subtypes based on objective sleep duration. This study identified three insomnia subtypes with different sleep durations and NREM spectral power, and found that acute sleep restriction improved multiple objective sleep measures across all insomnia subtypes.

SCIENTIFIC REPORTS (2021)

Article Psychology, Multidisciplinary

Self-Conscious Affect Is Modulated by Rapid Eye Movement Sleep but Not by Targeted Memory Reactivation-A Pilot Study

Risto Halonen et al.

Summary: The quality of rapid eye movement sleep (REMS) as well as individual vulnerability toward the stressor type may affect the potential of REMS in affective processing.

FRONTIERS IN PSYCHOLOGY (2021)

Article Clinical Neurology

Mode of delivery of Cognitive Behavioral Therapy for Insomnia: a randomized controlled non-inferiority trial of digital and face-to-face therapy

Havard Kallestad et al.

Summary: The study found that digital cognitive behavioral therapy (dCBT-I) performed significantly worse than individual face-to-face CBT-I in reducing insomnia severity, with results being inconclusive regarding the possible inferiority or non-inferiority. More clinical research is needed to clarify the optimal application of dCBT-I.
Article Clinical Neurology

Event-related potentials in insomnia reflect altered perception of sleep

Bernd Feige et al.

Summary: The study found a reduced P2 amplitude in insomnia patients during phasic REM sleep, which was correlated with sleep misperception. Independent component analysis showed that frontal negativity played a key role in this group difference.
Review Clinical Neurology

The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials

Leonie F. Maurer et al.

Summary: Sleep restriction therapy effectively improves insomnia severity and sleep continuity in the short term, with potential comparable efficacy to multicomponent cognitive-behavioural therapy; further studies are needed to assess long-term effects and effectiveness in clinical practice.

SLEEP MEDICINE REVIEWS (2021)

Article Clinical Neurology

Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States

Michael Darden et al.

Summary: The study found that fully automated digital cognitive behavioral therapy (CBT) is the most cost-effective treatment for insomnia in the United States, followed by group CBT, pharmacotherapy, and individual CBT. Utilizing automated digital CBT to treat insomnia at a population scale is financially prudent and beneficial from a societal perspective.
Article Clinical Neurology

Mode of delivery of Cognitive Behavioral Therapy for Insomnia: a randomized controlled non-inferiority trial of digital and face-to-face therapy

Havard Kallestad et al.

Summary: The study found that digital cognitive behavioral therapy for insomnia (dCBT-I) is comparable to individual face-to-face (FtF) CBT-I in reducing insomnia severity. However, dCBT-I performed worse than FtF CBT-I at both week 33 and week 9. More clinical research is needed to clarify the optimal application, dissemination, and implementation of dCBT-I.
Review Neurosciences

Sleep, insomnia, and depression

Dieter Riemann et al.

NEUROPSYCHOPHARMACOLOGY (2020)

Review Engineering, Biomedical

Profile of Somryst Prescription Digital Therapeutic for Chronic Insomnia: Overview of Safety and Efficacy

Charles M. Morin

EXPERT REVIEW OF MEDICAL DEVICES (2020)

Article Genetics & Heredity

Biological and clinical insights from genetics of insomnia symptoms

Jacqueline M. Lane et al.

NATURE GENETICS (2019)

Review Clinical Neurology

Insomnia as a predictor of mental disorders: A systematic review and meta-analysis

Elisabeth Hertenstein et al.

SLEEP MEDICINE REVIEWS (2019)

Article Clinical Neurology

Haunted by the past: old emotions remain salient in insomnia disorder

Rick Wassing et al.

Article Biochemistry & Molecular Biology

Restless REM Sleep Impedes Overnight Amygdala Adaptation

Rick Wassing et al.

CURRENT BIOLOGY (2019)

Article Neurosciences

Data-Driven Analysis of EEG Reveals Concomitant Superficial Sleep During Deep Sleep in Insomnia Disorder

Julie Anja Engelhard Christensen et al.

FRONTIERS IN NEUROSCIENCE (2019)

Article Multidisciplinary Sciences

Accurate whole-night sleep monitoring with dry-contact ear-EEG

Kaare B. Mikkelsen et al.

SCIENTIFIC REPORTS (2019)

Article Clinical Neurology

Long-Term Effects of an Unguided Online Cognitive Behavioral Therapy for Chronic Insomnia

Oystein Vedaa et al.

JOURNAL OF CLINICAL SLEEP MEDICINE (2019)

Editorial Material Clinical Neurology

The Value of Digital Insomnia Therapeutics: What We Know and What We Need To Know

Emerson M. Wickwire

JOURNAL OF CLINICAL SLEEP MEDICINE (2019)

Review Clinical Neurology

Cognitive behavioral therapy for insomnia: A meta-analysis of long-term effects in controlled studies

Tanja van der Zweerde et al.

SLEEP MEDICINE REVIEWS (2019)

Article Oncology

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial

Robert Zachariae et al.

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE (2018)

Review Clinical Neurology

A meta-analysis of associations between obesity and insomnia diagnosis and symptoms

Wai Sze Chan et al.

SLEEP MEDICINE REVIEWS (2018)

Article Oncology

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial

Robert Zachariae et al.

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE (2018)

Article Clinical Neurology

European guideline for the diagnosis and treatment of insomnia

Dieter Riemann et al.

JOURNAL OF SLEEP RESEARCH (2017)

Article Clinical Neurology

Sleep and cognitive performance: cross-sectional associations in the UK Biobank

Simon D. Kyle et al.

SLEEP MEDICINE (2017)

Review Clinical Neurology

Heart rate variability in insomnia patients: A critical review of the literature

Kirsty L. Dodds et al.

SLEEP MEDICINE REVIEWS (2017)

Review Clinical Neurology

Sleep and emotion regulation: An organizing, integrative review

Cara A. Palmer et al.

SLEEP MEDICINE REVIEWS (2017)

Article Neurosciences

Insomnia and Personality-A Network Approach

Kim Dekker et al.

BRAIN SCIENCES (2017)

Editorial Material Medicine, General & Internal

Cognitive Behavioral Therapy for Chronic Insomnia: Confronting the Challenges to Implementation

Roger G. Kathol et al.

ANNALS OF INTERNAL MEDICINE (2016)

Article Multidisciplinary Sciences

Slow dissolving of emotional distress contributes to hyperarousal

Rick Wassing et al.

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA (2016)

Article Psychology

Sleep and Mental Disorders: A Meta-Analysis of Polysomnographic Research

Chiara Baglioni et al.

PSYCHOLOGICAL BULLETIN (2016)

Article Clinical Neurology

Wake High-Density Electroencephalographic Spatiospectral Signatures of Insomnia

Michele A. Colombo et al.

Article Clinical Neurology

Wake High-Density Electroencephalographic Spatiospectral Signatures of Insomnia

Michele A. Colombo et al.

Review Clinical Neurology

The neurobiology, investigation, and treatment of chronic insomnia

Dieter Riemann et al.

LANCET NEUROLOGY (2015)

Article Clinical Neurology

The Nature of Stable Insomnia Phenotypes

Vivek Pillai et al.

Article Medicine, General & Internal

Insomnia disorder

Charles M. Morin et al.

NATURE REVIEWS DISEASE PRIMERS (2015)

Article Clinical Neurology

The Nature of Stable Insomnia Phenotypes

Vivek Pillai et al.

Article Multidisciplinary Sciences

Unobtrusive ambulatory EEG using a smartphone and flexible printed electrodes around the ear

Stefan Debener et al.

SCIENTIFIC REPORTS (2015)

Review Psychology, Clinical

Sleep-related attentional bias in insomnia: A state-of-the-science review

Kamelia Harris et al.

CLINICAL PSYCHOLOGY REVIEW (2015)

Article Psychology, Clinical

Guided internet cognitive behavioral therapy for insomnia compared to a control treatment - A randomized trial

Viktor Kaldo et al.

BEHAVIOUR RESEARCH AND THERAPY (2015)

Article Psychology, Clinical

The Role of Sleep in Emotional Brain Function

Andrea N. Goldstein et al.

ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 10 (2014)

Letter Cardiac & Cardiovascular Systems

Insomnia and risk of cardiovascular disease: A meta-analysis of cohort studies

Min Li et al.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2014)

Editorial Material Cell Biology

UK Biobank Data: Come and Get It

Naomi E. Allen et al.

SCIENCE TRANSLATIONAL MEDICINE (2014)

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The genetics of insomnia - Evidence for epigenetic mechanisms?

Laura Palagini et al.

SLEEP MEDICINE REVIEWS (2014)

Review Clinical Neurology

Sleep changes. in the disorder of insomnia: A meta-analysis of polysomnographic studies

Chiara Baglioni et al.

SLEEP MEDICINE REVIEWS (2014)

Article Medicine, General & Internal

The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder

Colin A. Espie et al.

BMJ OPEN (2014)

Article Psychology, Biological

The microstructure of sleep in primary insomnia: An overview and extension

Bernd Feige et al.

INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY (2013)

Article Clinical Neurology

Stepped Care for Insomnia: an Evaluation of Implementation in Routine Practice

Norah Vincent et al.

JOURNAL OF CLINICAL SLEEP MEDICINE (2013)

Review Clinical Neurology

Insomnia with objective short sleep duration: The most biologically severe phenotype of the disorder

Alexandros N. Vgontzas et al.

SLEEP MEDICINE REVIEWS (2013)

Article Clinical Neurology

Use of the Internet and Mobile Media for Delivery of Cognitive Behavioral Insomnia Therapy

Colin A. Espie et al.

SLEEP MEDICINE CLINICS (2013)

Article Psychology, Biological

Increased EEG sigma and beta power during NREM sleep in primary insomnia

Kai Spiegelhalder et al.

BIOLOGICAL PSYCHOLOGY (2012)

Article Psychiatry

Meta-Analysis of Sleep Disturbance and Suicidal Thoughts and Behaviors

Wilfred R. Pigeon et al.

JOURNAL OF CLINICAL PSYCHIATRY (2012)

Article Clinical Neurology

Insomnia Pharmacotherapy

Timothy Roehrs et al.

NEUROTHERAPEUTICS (2012)

Review Pharmacology & Pharmacy

REM Sleep Instability - A New Pathway for Insomnia?

D. Riemann et al.

PHARMACOPSYCHIATRY (2012)

Article Clinical Neurology

The Consensus Sleep Diary: Standardizing Prospective Sleep Self-Monitoring

Colleen E. Carney et al.

Review Clinical Neurology

Acute insomnia: Current conceptualizations and future directions

Jason G. Ellis et al.

SLEEP MEDICINE REVIEWS (2012)

Review Clinical Neurology

Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies

Chiara Baglioni et al.

JOURNAL OF AFFECTIVE DISORDERS (2011)

Review Pharmacology & Pharmacy

Chronic Insomnia: Clinical and Research Challenges - An Agenda

D. Riemann et al.

PHARMACOPSYCHIATRY (2011)

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Histamine in the regulation of wakefulness

Mahesh M. Thakkar

SLEEP MEDICINE REVIEWS (2011)

Article Psychology, Clinical

Sleep disturbance as transdiagnostic: Consideration of neurobiological mechanisms

Allison G. Harvey et al.

CLINICAL PSYCHOLOGY REVIEW (2011)

Review Clinical Neurology

The hyperarousal model of insomnia: A review of the concept and its evidence

Dieter Riemann et al.

SLEEP MEDICINE REVIEWS (2010)

Review Clinical Neurology

The role of personality traits in insomnia

Merijn van de Laar et al.

SLEEP MEDICINE REVIEWS (2010)

Editorial Material Psychology, Applied

Sleep, Self-Regulation, Self-Control and Health

Martin S. Hagger

STRESS AND HEALTH (2010)

Article Psychology, Clinical

Psychophysiological reactivity to sleep-related emotional stimuli in primary insomnia

Chiara Baglioni et al.

BEHAVIOUR RESEARCH AND THERAPY (2010)

Article Psychiatry

The epidemiology of insomnia: Associations with physical and mental health. The HUNT-2 study

Borge Sivertsen et al.

JOURNAL OF PSYCHOSOMATIC RESEARCH (2009)

Review Medical Laboratory Technology

Genomic and personalized medicine: foundations and applications

Geoffrey S. Ginsburg et al.

TRANSLATIONAL RESEARCH (2009)

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Sleep and affect in older adults: using multilevel modeling to examine daily associations

Christina S. Mccrae et al.

JOURNAL OF SLEEP RESEARCH (2008)

Article Business

Insomnia, emotions, and job satisfaction: A multilevel study

Brent A. Scott et al.

JOURNAL OF MANAGEMENT (2006)

Review Clinical Neurology

Recommendations for a standard research assessment of insomnia

Daniel J. Buysse et al.

Article Neurosciences

Homeostatic, circadian, and emotional regulation of sleep

CB Saper et al.

JOURNAL OF COMPARATIVE NEUROLOGY (2005)

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Hypothalamic regulation of sleep and circadian rhythms

CB Saper et al.

NATURE (2005)

Review Clinical Neurology

Cognitive behaviour therapy for primary insomnia: Can we rest yet?

AG Harvey et al.

SLEEP MEDICINE REVIEWS (2003)

Review Psychology, Clinical

A cognitive model of insomnia

AG Harvey

BEHAVIOUR RESEARCH AND THERAPY (2002)

Review Clinical Neurology

Epidemiology of insomnia: what we know and what we still need to learn

MM Ohayon

SLEEP MEDICINE REVIEWS (2002)