Predictors of Cognitive Behavioral Therapy for Insomnia in Older Adults

OBJECTIVES: Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended non-pharmacological treatment for insomnia in adults; however, it remains unclear which older adults are most likely to benefit from CBT-I. METHODS: Data from a Randomized Controlled Trial (RCT) examining the effect of CBT-I on cognitive performance in older adults were used for this study. Ninety-six older adults with insomnia received six weeks of CBT-I and were assessed at baseline, immediately following treatment, and at the 12-month follow-up. Ten baseline variables, including demographic, psychological, and sleep-related characteristics, were included in linear regression to examine their association with CBT-I success, defined as the Insomnia Severity Index (ISI) scores after six weeks of CBT-I and at the one-year follow-up. RESULTS: < .01) with lower ISI scores at the 12-month follow-up. CONCLUSION: Six weeks of CBT-I resulted in significant and sustained reductions in insomnia severity in older adults. Baseline sleep self-efficacy and depression severity significantly predicted lower insomnia severity following CBT-I, whereas only sleep self-efficacy predicted the long-term maintenance of treatment gains. These findings underscore the importance of baseline sleep self-efficacy as key predictor for optimizing treatment planning and long-term outcomes.