OBJECTIVE Treatments that alleviate insomnia over the long term are critical. We evaluated the relative long-term efficacy of cognitive therapy (CT), behavior therapy (BT), and cognitive behavior therapy (CBT) for insomnia. METHOD Patients (N = 188, 62.2% female, 81.1% White, 6.5% Hispanic or Latinx, Mage = 47.4 years) with insomnia were randomized to eight sessions of CT, BT, or CBT for insomnia. Assessments at pretreatment and 12-month follow-up measured insomnia severity, insomnia response/remission, sleep diary parameters, and daytime functioning. RESULTS Patients in all three treatment groups improved on insomnia severity, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, work and social adjustment, and mental health (ps < .05). Moreover, in each treatment group, a substantial proportion of patients achieved remission and response. CBT was associated with larger improvements in insomnia severity relative to CT as well as greater remission and improvements in physical health, relative to CT and BT (ps < .05). For patients with a psychiatric comorbidity, CBT was associated with greater improvements in work and social adjustment and mental health, relative to CT (ps < 0.05). CT was not associated with change in time in bed, and none of the treatment conditions were associated with change in daytime fatigue (ps > .05). CONCLUSIONS These encouraging results suggest that therapists may be able to offer CBT, BT, or CT to improve nighttime and daytime symptoms of insomnia over the long-term, with CBT offering a relative advantage for select outcomes and subgroups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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十二个月随访：认知疗法、行为疗法、认知行为疗法对失眠患者的疗效比较。

目的 长期缓解失眠的治疗至关重要。我们评估了认知疗法（CT）、行为疗法（BT）和认知行为疗法（CBT）治疗失眠的相对长期疗效。方法 失眠症患者（N = 188，其中 62.2% 为女性，81.1% 为白人，6.5% 为西班牙裔或拉丁裔，法师 = 47.4 岁）随机接受 8 次失眠 CT、BT 或 CBT 治疗。治疗前和 12 个月随访时的评估测量了失眠严重程度、失眠反应/缓解、睡眠日记参数和日间功能。结果 所有三个治疗组的患者在失眠严重程度、入睡潜伏期、入睡后觉醒、总睡眠时间、睡眠效率、工作和社会适应以及心理健康方面均有所改善 (ps < .05)。此外，在每个治疗组中，相当一部分患者获得了缓解和缓解。相对于 CT 而言，CBT 与失眠严重程度的更大程度改善相关，并且相对于 CT 和 BT 而言，CBT 与更大程度的缓解和身体健康改善相关 (ps < .05)。对于患有精神共病的患者，相对于 CT，CBT 与工作、社会适应和心理健康的更大改善相关（ps < 0.05）。CT 与卧床时间的变化无关，并且所有治疗条件均与日间疲劳的变化无关 (ps > .05)。结论 这些令人鼓舞的结果表明，从长远来看，治疗师可能能够提供 CBT、BT 或 CT 来改善夜间和白天的失眠症状，其中 CBT 对于特定的结果和亚组具有相对优势。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。