Efficacy of Cognitive Behavioral Therapy for Insomnia in Geriatric Primary Care Patients

Gregory A. Hinrichsen PhD; Rosanne M. Leipzig MD, PhD


J Am Geriatr Soc. 2021;69(10):2993-2995. 

In This Article


Frailty, pain, nocturia, cognitive limitations, and late evening/early morning medical/medication regimens can interfere with sleep especially among very old patients and may make insomnia more difficult to treat. Nonetheless, among a group of predominantly old-old and oldest old patients, we found that CBT-I is a highly effective treatment for chronic insomnia. Findings were similar to those of a randomized clinical trial of behavioral treatment of chronic insomnia that was briefer than described in this report (four sessions), delivered by a non-sleep specialist (in person and then telephone sessions) to a group of older adults who were almost 6 years younger than those in our study.[11] The strengths of this study include participation of individuals older than in previous CBT studies, and a model of care providing colocation and partnership between primary care geriatricians and a geropsychologist. Limitations are that patients were predominantly white and well-educated and it is unclear whether CBT-I would be of interest or effective in other patient populations of advanced age.