Brief Cognitive Behavioral Treatment for Insomnia Cuts Costs

With as few as three cognitive therapy treatments, patients can see significant improvement in sleep and reduced medical costs. This study shows how addressing sleep disorders can reduce health-care costs and improve patient outcomes for overall wellness. This research is the first to outline how brief treatments with cognitive behavioral therapy for insomnia (CBTI) can decrease health care utilization (HCU) costs.

The study results appeared in the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine. Sleep improved in 86 percent of insomnia patients who completed at least three sessions of CBTI. And, in six months after the treatment, health care utilization decreased and health care-related costs were reduced by more than $200 on average among those who completed the treatment.

“Cognitive behavioral therapy for insomnia is a highly effective treatment, and this study shows that a relatively brief intervention also may have a positive economic impact,” said principal investigator Christina McCrae, PhD, associate professor of clinical and health psychology at the University of Florida in Gainesville, Fla in Science Daily. “Insomnia remains an undertreated disorder, and brief cognitive behavioral therapy can help to increase access to care and reduce the burden of insomnia.”

Researchers at the VA Pittsburgh Healthcare System and Drexel University in Philadelphia, McCrae reviewed 84 outpatient medical records  of those treated in a behavioral sleep medicine clinic, located in an accredited sleep disorders center. The treatment included a combination of sleep education, sleep hygiene, stimulus control therapy, sleep restriction, a 10-minute relaxation exercise, and cognitive therapy.

Patients attended up to six weekly treatment sessions, which were led by clinical psychology graduate students and predoctoral interns. The costs were calculated over a six-month period prior to and following treatment, including: 1. number of physician office visits, 2. costs related to office visits, 3. number of medications, and 4. estimated health care costs and utilization.

The cost of brief treatment with CBTI was about $460. The authors note that this initial cost may negate the short-term savings during the first six months after treatment. However, the study shows the advantage of CBTI is that the effects are long-term. This in turn means there is no need for ongoing treatment costs. The study authors report that CBTI has the potential to produce substantial long-term savings. It is estimated that the sleep deprivation costs American business $63b a year in lost productivity. It is estimated that as many as 40% of adults suffer from some form of insomnia, and 15% suffer from chronic insomnia.