Dermatology & Plastic Surgery Institute Outcomes
Sleep Disorders
Insomnia
Insomnia is a common sleep disorder, characterized by the inability to initiate or maintain sleep or early morning awakening despite the opportunity to sleep. Cognitive behavioral therapy for insomnia (CBT-I), which does not involve sedative-hypnotic medications, is one of the most effective treatments for insomnia. Traditionally, CBT-I has been provided by a behavioral sleep medicine specialist in individual or group therapy sessions. Patients are evaluated and treated for insomnia with CBT-I by a behavioral sleep medicine expert at the Sleep Disorders Center. Meta-analyses have shown better and more durable outcomes in insomnia patients using CBT-I compared with using sedative-hypnotic medications alone.
Improvement in Insomnia-Related Symptoms Following Individual CBT-I
2021 – 2022
CBT-I = cognitive behavioral therapy for insomnia, ESS = Epworth Sleepiness Scale, ISI = Insomnia Severity Index, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System, TST = total sleep time
311 patients had at least 2 visits in 2021–2022 with ESS data available for analysis. Among those patients whose baseline ESS score ≥ 10 (N = 94), 35.1% (N = 33) improved, 56.4% (N = 53) remained stable, and 8.5% (N = 8) worsened. Median duration of follow-up was 200 days (range, 12-703 days). Clinically meaningful change was defined as a total score change of 3, based on one-half the standard deviation.¹
322 patients had at least 2 visits in 2021–2022 with ISI data available for analysis. Among those patients whose baseline ISI score ≥ 10 (N = 272), 58.8% (N = 160) improved, 34.9% (N = 95) remained stable, and 6.2% (N = 17) worsened. Median duration of follow-up was 168 days (range, 19-700 days). Clinically meaningful change was defined as a total score change of 3, based on one-half the standard deviation.¹
361 patients had at least 2 visits in 2021–2022 with PHQ-9 data available for analysis. Among those patients whose baseline PHQ-9 score ≥ 10 (N = 152), 35.5% (N = 54) improved, 53.3% (N = 84) remained stable, and 9.2% (N = 14) worsened. Median duration of follow-up was 332days (range, 21-707 days). Clinically meaningful change was defined as a total score change of 5, based on one-half the standard deviation.²
308 patients had at least 2 visits in 2021–2022 with PROMIS Mental Health data available for analysis. Among those patients whose baseline PROMIS Mental Health score ≤ 45 (N = 182), 33% (N = 60) improved, 59.3% (N = 108) remained stable, and 7.7% (N = 14) worsened. Median duration of follow-up was 412 days (range, 3-713 days). Clinically meaningful change was defined as a 5-unit change in T-score, based on one-half the standard deviation.¹
310 patients had at least 2 visits in 2021–2022 with PROMIS Physical Health data available for analysis. Among those patients whose baseline PROMIS Physical Health score ≤ 45 (N = 171), 30.4% (N = 52) improved, 59.1% (N = 101) remained stable, and 10.5% (N = 18) worsened. Median duration of follow-up was 435 days (range, 3-713 days). Clinically meaningful change was defined as a 5-unit change in T-score, based on one-half the standard deviation.¹
339 patients had at least 2 visits in 2021–2022 with PROMIS Sleep Disturbance data available for analysis. Among those patients whose baseline PROMIS Sleep Disturbance T-score ≥ 55 (N = 248), 54% (N = 134) improved, 38.7% (N = 96) remained stable, and 7.3% (N = 18) worsened. Median duration of follow-up was 222 days (range, 28-706 days). Clinically meaningful change was defined as a 5-unit change in T-score, based on one-half the standard deviation.¹
154 patients had at least 2 visits in 2021–2022 with TST data available for analysis. Among those patients whose baseline TST ≤ 24 hours (N = 154), 41.6% (N = 64) improved, 40.9% (N = 63) remained stable, and 17.5% (N = 27) worsened. Median duration of follow-up was 247 days (range, 7-658 days). Clinically meaningful change was defined as a 1-hour change, based on one-half the standard deviation.¹
