La thérapie cognitivocomportementale de l'insomnie primaire est-elle efficace dans le cadre clinique ?

Cognitive behavioural therapy for insomnia (CBT-I) has been largely demonstrated in randomised controlled trials (RCTs) with primary and, more recently, comorbid insomnia patients. Effectiveness trials of CBT-I in clinical settings are less documented. However, the extrapolation of RCT data, often obtained in highly selected patients, to routine clinical settings is less evident. The aim of this study was to examine the effectiveness of CBT-I for primary insomnia via an uncontrolled prospective study in a clinical care setting, posttreatment and at 6 months follow-up. This study was performed on 59 patients with primary insomnia, mostly referred by their GP or medical specialist to the Leuvens Universitair Centrum voor Slaap/Waakstoornissen, who followed a six weeks course of CBT-I in-group. Effects of CBT-I on several sleep parameters were studied, next to the impact on daytime functioning and medication use immediately after treatment and at 6 months follow-up. CBT-I resulted in an overall increase in sleep satisfaction, an improved daytime functioning and a reduction in the use of sleep promoting agents after CBT-I treatment and at 6 months follow-up. In conclusion, this study, conducted in a clinical care setting with primary insomnia patients, confirms the results of RCT's on the effectiveness of CBT-I on sleep quality, medication use and daytime functioning, even after 6 months follow-up.