Integration of Cognitive Behavioral Therapy for Insomnia

Insomnia, characterized by difficulty falling or staying asleep and associated daytime impairments, is experienced by approximately 30-50% of the general population and is associated with significant negative physical, psychological, and financial outcomes. Insomnia is highly comorbid with other psychological and medical disorders (e.g., posttraumatic stress disorder, major depressive disorder) and typically persists after successful treatment of the other complaint. Clearly, insomnia is a significant problem that should be addressed by providers treating individuals with other psychological complaints, yet sleep problems are frequently ignored or improperly treated, and current treatments of most comorbid psychological and medical disorders do not directly address insomnia. The emergence of sleep psychology interventions for insomnia (e.g., cognitive behavioral therapy for insomnia [CBT-I]) has provided a promising route to efficacious treatment of insomnia that avoids the drawbacks of hypnotic medications. Moreover, contemporary research studies are testing the integration of the sleep psychotherapies previously validated in pure primary insomnia into comorbid populations as well as new settings, populations, and delivery methods. The goal of this special section was to publish new, innovative, and cutting-edge approaches to CBT-I, which would serve to significantly improve the science as well as the care of those with comorbid insomnia. Two articles examining future directions of CBT-I and sleep psychology broadly are published here. The existing body of evidence, as well as the articles in this special section, provides compelling evidence for practitioners, regardless of their primary theoretical orientation, to engage in technical eclecticism as a matter of best practice for treatment of insomnia.