CBT-I CBT-I Special Populations & Comorbidities

Question 1

When applying CBT-I to older adults, which modification is most commonly needed?

Accepted Answer

Using a less aggressive sleep restriction with a floor of at least 6 hours

Answer

Older adults may be more sensitive to sleep deprivation, so the minimum sleep window is typically kept at 6 hours rather than 5.

Question 2

CBT-I is considered first-line treatment for insomnia comorbid with which conditions?

Accepted Answer

Depression, anxiety, and chronic pain conditions

Answer

Evidence supports CBT-I as first-line across a wide range of comorbidities, including mood disorders and chronic pain.

Question 3

In patients with PTSD and insomnia, which CBT-I component requires special consideration?

Accepted Answer

Stimulus control — specifically the instruction to get out of bed

Answer

For PTSD patients, the out-of-bed instruction may be contraindicated if it exposes them to unsafe environments or triggers trauma-related responses.

Question 4

Which aspect of CBT-I typically needs modification for patients with chronic pain?

Accepted Answer

Sleep restriction, since pain may make extended wakefulness more distressing

Answer

Sleep restriction may exacerbate pain sensitivity, so the protocol is often delivered more slowly with less aggressive restriction.

Question 5

CBT-I for patients with major depressive disorder should be:

Accepted Answer

Delivered concurrently with depression treatment as it improves both outcomes

Answer

Research shows that treating insomnia with CBT-I concurrently with depression treatment improves both sleep and mood outcomes.

(CBT-I) CBT Insomnia Certification Practice Test