2016 - 2019

Abstract

Introduction: Cognitive Behavioral Therapy is the most recommended treatment for insomnia. Acceptance, mindfulness and values-based actions may constitute complementary therapeutic tools to CBT-I (Cognitive Behavioral Therapy for Insomnia). Acceptance and Commitment Therapy for Insomnia (ACT-I) is a classical ACT program including the main recommended components of CBT-I (sleep restriction and control stimulus). The objective of the current study was to evaluate the efficacy of remotely delivered ACT-I in adults with chronic insomnia and hypnotic dependence.

Methods: 32 participants were enrolled in a pilot randomized controlled trial:  Half of them waited 3 months before participating in the four ACT-I sessions. Outcomes variables included sleep quality, severity of sleep disturbance, quality of life, use of hypnotics, anxiety and depression. They were evaluated with standard questionnaires and a sleep diary at both pre- to post treatment and follow-up (1 - 6 months post-treatment).

Results: We found a large effect size for nocturnal and daytime improvements, and increased quality of life and acceptance. Increased hypnotic use in waiting-list participants and conversely, decreased consumption in ACT-I group were observed.

Conclusion: Web-based ACT-I is efficient to treat chronic insomnia and hypnotic dependence.

Protocol

  • Pilot Randomized Controlled Trial: treatment versus waiting list
  • Pre-treatment - Post-treatment - Follow-up 6 month
  • 4 sessions of individual CBT

Funding

  • Funding: April Foundation
  • Funding applicant: Benjamin Putois
  • Institution: Association nationale pour la promotion de la connaissance sur le sommeil
  • Institutional partner: INSERM

Contributors

  • Research Coordinator, Psychologist-Psychotherapist, Statistician: Benjamin Putois.
  • Responsible physician: Dr Hélène Bastuji, Praticien Hospitalier en Neurologie, Médecin Coordonnateur de la Fédération des Unités d’Exploration et de Traitement des Troubles du Sommeil des HCL. Unité d’hypnologie, Hôpital Neurologique, 59, bd Pinel 69677 Bron
  • Physician Partner: Dr Laure Peter-Derex, Médecin Neurologue, CHU de LYON, Service de Neurologie-sommeil, Hôpital Lyon Sud, Pierre Bénite.
  • Physician Partner: Dr Thierry Faivre, Médecin psychiatre, Clinique Lyon-Lumière 33B, rue du 8 mai 1945, 69330 Meyzieu France.
  • Psychologist: Mélinée Chapoutot. Psychologue clinicien. Association Nationale de Promotion des connaissances sur le sommeil. 292 rue Vendôme. 69003 Lyon.
  • ACT supervisor: Benjamin Schoendorff. Psychologue clinicien, formateur et superviseur de la thérapie d’acceptation et d’engagement Institut de Psychologie Contextuelle. 341, de Ramsay, Mont-Saint-Hilaire. Canada.

Publications & Communications

  • Chapoutot, M., Peter-Derex, L., Schoendorff, B., Bastuji, H., Putois B., (en soumission). A pilot Randomized Controlled Trial of Internet-delivered Acceptance and Commitment Therapy in the treatment of insomnia and hypnotic dependence.
  • Putois, B.J. & Chapoutot, M. (en soumission). Faire la paix avec son sommeil - Thérapie d’acceptation et d’engagement pour l’insomnie de l’adulte
  • Chapoutot, M., Faivre, T., Leslie, W., & Putois, B. (2015). Insomnia in adults: Symptoms, Diagnosis and Therapy. Advances in Medicine and Biology, 92, 22-45.
  • Chapoutot, M., Faivre, T., Juenet, N., Higgins, S., Alsaman, L., Ben Djrad, K., Putois, B.J. (2013). Validation française de l'échelle de sévérité de la dépendance aux benzodiazépines et apparentés chez des patients présentant une plainte de sommeil. Congrès du sommeil, Société Française de Recherche en Médecine du Sommeil (France).
  • Putois, B. (2016). Thérapies Cognitivo-Comportementales dans les troubles du sommeil. DIU Physiologie et pathologie du sommeil, Université Lyon 1, Lyon.