Sleep-related predictors of cognition among adults with chronic insomnia and heart failure enrolled in a randomized controlled trial of cognitive behavioral therapy for insomnia
- S-Med
- 4 days ago
- 2 min read
Our findings suggest that CBT-I may improve cognition among people with chronic HF and insomnia. Notably, the odds of improved self-reported cognition and less than 3 PVT-measured lapses in the CBT-I group were about twice the odds of improvement in the attention control condition, although there was only a significant group-time effect for the proportion with improvements in self-reported cognition.
Although these findings must be interpreted cautiously and the study was not powered for the cognitive outcomes, our study is considerably larger than previous studies of the effects of CBT-I on cognition that included samples of 10 and 12 members of non-HF populations and no control conditions. Only 1 study of Spanish-speaking people with insomnia and normal baseline cognition found improvements from normal to high normal in multiple measure of cognition. The second study, conducted in people with mild CI and insomnia, found no effects on the Montreal Cognitive Assessment, a screening scale for mild cognitive dysfunction that elicits attention and concentration, executive functions, memory, language, visuo-construction skills, conceptual thinking, calculations, and orientation despite improvements in insomnia. Notably, the latter study included people with insomnia and mild CI at baseline who were successfully able to complete CBT-I.
Trends suggesting improvements in cognitive variables are in addition to the sustained effects of CBT-I on insomnia severity, sleep characteristics, fatigue, sleepiness, and function, including SMWD found in the parent study Future randomized controlled trials that are fully powered to test the effects of CBT-I on multidimensional cognitive outcomes are needed to confirm the effects found in this study and to determine whether improved cognition is a direct effect of the intervention or a result of improvements in insomnia, sleepiness, sleep characteristics, stress, or other factors that improved in the parent trial.
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