CBT-I CBT-I Treatment Outcomes & Research Evidence 1 — Questions and Answers
Question 1: Which organizations have endorsed CBT-I as the first-line treatment for chronic insomnia in adults?
- American Heart Association only
- American Academy of Sleep Medicine (AASM) and American College of Physicians (ACP) (Correct answer)
- World Health Organization only
- National Institutes of Health only
Correct answer: American Academy of Sleep Medicine (AASM) and American College of Physicians (ACP)
Both the AASM and the ACP have issued clinical practice guidelines recommending CBT-I as the first-line treatment for chronic insomnia.
Question 2: Compared to sleep medication, CBT-I demonstrates:
- Faster short-term effects but equal long-term effects
- Similar short-term and superior long-term effects with maintained gains after treatment ends (Correct answer)
- Inferior effects at all time points
- Benefits limited to sleep onset insomnia only
Correct answer: Similar short-term and superior long-term effects with maintained gains after treatment ends
CBT-I produces comparable short-term effects and superior long-term outcomes because gains persist after treatment ends, unlike medication effects that diminish when discontinued.
Question 3: The typical response rate for CBT-I in randomized controlled trials is approximately:
- 20-30%
- 50-60%
- 70-80% (Correct answer)
- 95-100%
Correct answer: 70-80%
Meta-analyses consistently show 70-80% of patients achieve clinically meaningful improvements with CBT-I.
Question 4: The Insomnia Severity Index (ISI) clinical response is defined as a reduction of at least how many points?
- 2 points
- 6 points (Correct answer)
- 10 points
- 15 points
Correct answer: 6 points
A reduction of 6 or more points on the ISI is the accepted threshold for clinically meaningful response in insomnia treatment research.
Question 5: Which component of CBT-I has the strongest evidence base as a standalone intervention?
- Sleep hygiene education
- Stimulus control therapy (Correct answer)
- Relaxation training
- Cognitive restructuring alone
Correct answer: Stimulus control therapy
Stimulus control therapy has the most robust evidence as a single-component intervention, with decades of research demonstrating its efficacy.
Question 6: Sleep diary data used in CBT-I outcome measurement primarily tracks which variables?
- Polysomnography data
- Sleep efficiency, total sleep time, and sleep onset latency (Correct answer)
- Actigraphy movement counts
- Cortisol awakening response
Correct answer: Sleep efficiency, total sleep time, and sleep onset latency
Sleep diary captures subjective measures of sleep efficiency, TST, SOL, and WASO, which are the primary CBT-I outcome variables.
CBT-I CBT-I Treatment Outcomes & Research Evidence 1
Which organizations have endorsed CBT-I as the first-line treatment for chronic insomnia in adults?