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Sleep spindles may predict response to cognitive behavioral therapy for chronic insomnia


Sleep spindles may predict response to cognitive behavioral therapy for chronic insomnia

Dang-Vu, Thien Thanh, Hatch, Benjamin, Salimi, Ali, Mograss, Melodee A, Boucetta, Soufiane, O’byrne, Jordan, Brandewinder, Marie, Berthomier, Christian and Gouin, Jean-Philippe (2017) Sleep spindles may predict response to cognitive behavioral therapy for chronic insomnia. Sleep Medicine . ISSN 13899457 (In Press)

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Official URL: http://dx.doi.org/10.1016/j.sleep.2017.08.012


While cognitive-behavioral therapy for insomnia constitutes the first-line treatment for chronic insomnia, only few reports have investigated how sleep architecture relates to response to this treatment. In this pilot study, we aimed at determining whether sleep spindle density at pre-treatment predicts treatment response to cognitive behavioral therapy for insomnia.

Twenty-four participants with chronic primary insomnia took part in a 6-week cognitive behavioral therapy for insomnia performed in groups of 4 to 6 participants. Treatment response was assessed using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index measured at pre- and post-treatment and at 3- and 12-months follow-up assessments. Secondary outcome measures were extracted from sleep diaries over seven days and one overnight polysomnography, obtained at pre- and post-treatment. Spindle density during stages N2-N3 sleep was extracted from polysomnography at pre-treatment. Hierarchical linear modeling analysis assessed whether sleep spindle density predicted response to cognitive behavioral therapy.

After adjusting for age, sex and education level, lower spindle density at pre-treatment predicted poorer response over the 12-months follow-up, as reflected by smaller reduction in Pittsburgh Sleep Quality Index over time. Reduced spindle density also predicted lower improvements in sleep diary sleep efficiency and wake after sleep onset immediately after treatment. There were no significant associations between spindle density and changes in the Insomnia Severity Index or polysomnography variables over time.

These preliminary results suggest that inter-individual differences in sleep spindle density in insomnia may represent an endogenous biomarker predicting responsiveness to cognitive behavioral therapy. Insomnia with altered spindle activity might constitute an insomnia subtype characterized by a neurophysiological vulnerability to sleep disruption associated with impaired responsiveness to cognitive behavioral therapy.

Divisions:Concordia University > Faculty of Arts and Science > Exercise Science
Item Type:Article
Authors:Dang-Vu, Thien Thanh and Hatch, Benjamin and Salimi, Ali and Mograss, Melodee A and Boucetta, Soufiane and O’byrne, Jordan and Brandewinder, Marie and Berthomier, Christian and Gouin, Jean-Philippe
Journal or Publication:Sleep Medicine
Date:9 September 2017
  • Canadian Institutes of Health Research (CIHR, MOP 142191, PJT 153115)
  • Natural Sciences and Engineering Research Council of Canada (NSERC)
  • Fonds de Recherche du Québec – Santé (FRQ-S)
  • Canada Foundation for Innovation (CFI)
  • American Sleep Medicine Foundation (ASMF)
  • Pharmaprix
  • Centre de Recherches de l’Institut Universitaire de Gériatrie de Montréal
Digital Object Identifier (DOI):10.1016/j.sleep.2017.08.012
Keywords:electroencephalography; sleep spindles; neural oscillations; biomarkers; insomnia
ID Code:983025
Deposited On:13 Sep 2017 19:52
Last Modified:01 Sep 2018 00:01


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