CBT-I Special Populations & Comorbidities Flashcards

When treating insomnia in cancer patients, which unique factor must be incorporated into the CBT-I case conceptualization?

Answer: Treatment-related symptoms such as pain, nausea, and hot flashes that disrupt sleep

Cancer treatment side effects like pain, hot flashes, and nausea interact with insomnia and must be incorporated into the CBT-I case conceptualization.

CBT-I adaptations for individuals with bipolar disorder most importantly include:

Answer: Eliminating sleep restriction due to risk of triggering mania

Sleep restriction is generally avoided in bipolar disorder because sleep deprivation can trigger manic episodes.

For patients with generalized anxiety disorder and insomnia, treatment should:

Answer: Target both conditions, as they share maintaining mechanisms

GAD and insomnia share hyperarousal and worry as maintaining factors, and integrated treatment targeting both produces better outcomes.

Which sleep-related comorbidity must be identified and treated before CBT-I can be fully effective?

Answer: Obstructive sleep apnea (OSA)

Untreated OSA fragments sleep mechanically, which can undermine CBT-I outcomes; OSA should be identified and treated alongside or before CBT-I.

In treating insomnia in adolescents with CBT-I, what key biological factor must be considered?

Answer: Delayed circadian phase that conflicts with early school schedules

Adolescents have a biologically delayed circadian phase, meaning school start times often conflict with their natural sleep timing.

Insomnia co-occurring with shift work differs from typical insomnia because it involves:

Answer: Circadian misalignment as a key etiological factor alongside conditioned arousal

Shift work insomnia requires addressing both the behavioral and circadian components, sometimes including light therapy and strategic napping.