Effects of Cognitive Behavior Treatment for Insomnia (CBT-I) on Insomnia, Depression and Fatigue in Patients with Multiple Sclerosis (MS)

Background: The prevalence of sleep disorders among patients with Multiple Sclerosis (MS) is high.  According to a recent survey of approximately 7,700 individuals with MS, over half (56%) reported sleep disturbances, including insomnia (Tyry, Salter & Marrie, 2013).   Insomnia, or difficulties with initiating or maintaining sleep, is linked with deleterious effects on both physical and mental health.   Several studies have demonstrated significant relationships among insomnia, fatigue and depression for people with MS (Bamer, Johnson, Amtmann & Kraft, 2010; Fleming & Pollak, 2005; Merlino, Fratticci, Lenchig, Valente, Cargnelutti, Picello, Serafini, Dolso & Gigli, 2009; Najafi, Toghianifar, Etemadifar, Haghighi, Maghzi & Akbari, 2013; Stanton, Barnes & Silber, 2006).  To date, however, there is no research that examines the effects of psychotherapeutic treatment that targets sleep disorders within this population. 

Objectives: The purpose of this research is to evaluate the effectiveness of Cognitive Behavior Therapy for Insomnia (CBT-I) for patients with Multiple Sclerosis (MS).  In accordance with the literature that links insomnia with higher rates of depression and fatigue within this population, this study will examine the effects of CBT-I on individuals’ experiences of insomnia, depression and fatigue.

Methods: A retrospective outcome data analysis will be conducted for patients with Multiple Sclerosis (MS) who have participated in individual or group CBT-I at the Neurological Institute’s Sleep Disorders Center at the Cleveland Clinic Foundation (CCF).  The proposed sample will include all patients with a diagnosis of both MS and Insomnia who participated in individual or group CBT-I sessions at CCF’s Sleep Disorders Center between 2008-2013.  Scores from the following self-report measures, Patient Health Questionnaire (PHQ-9), Fatigue Severity Scale (FSS) and Insomnia Severity Index (ISI) will be used to assess depression, fatigue and insomnia, respectively, at pre- and post-treatment intervals.

Results:  The data analysis is in progress.  Results will be provided at the 2014 CMSC conference.

Conclusions: Conclusions will be provided at the 2014 CMSC conference.