Effect of Psychological Mediators on Cognitive Behavioral Therapy for Insomnia

Abstract

Studies recognize cognitive behavioral therapy for insomnia (CBT-I) as empirically effective; however, few studies have examined its therapeutic mechanism. This study attempts to remedy that gap by examining the mediation effects of cognitive behavioral factors on the improvement of insomnia symptoms. We extracted six studies after doing a literature search on PsycINFO, PubMed, CiNii, and medical online journals for the terms insomnia, CBT-I, mechanism, and mediator in both English and Japanese. Four studies indicate that dysfunctional beliefs about sleep, safety behavior, rise time variability, and pre-sleep arousal may mediate improvement of insomnia. This paper ends by discussing future research in understanding CBT-I mechanisms. It would be important for future studies to (a) develop assessments for cognitive behavioral factors about insomnia, (b) examine mediating effect including some cognitive behavioral factors, and (c) develop intervention techniques to safety behavior.