Evidence map›Paper›PMID 29619651›Full record

ReviewJournal of general internal medicine2018

Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review.

Erin Koffel, Adam D Bramoweth, Christi S Ulmer

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04962087 (Randomized Controlled Trial to Evaluate Health enSuite Insomnia), which is not on this map. Cited by 219 papers, 28 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
219citing papers in PubMed, 28 pooled it
16.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04962087 narecruitingnot on this mapstarted 2024, after this paper: background citation

Randomized Controlled Trial to Evaluate Health enSuite Insomnia: an App-based Treatment for Adult Chronic Insomnia

TypeinterventionalSponsorIWK Health CentreRan2024 to 2026Enrolled415ConditionsInsomniaArmsExperimental: Health enSuite Insomnia
3 · Its place in the literature

Who cites it

219 citing papers in PubMed, 28 syntheses or guidelines pooled it, 366 citations in OpenAlex.

  1. Pooled it
  2. Acceptance and commitment therapy for insomnia: an updated meta-analysis of randomized controlled trials.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
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  5. Combination treatment for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Guideline
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  20. Representation of race and ethnicity among cancer survivors in trials of cognitive behavioral therapy for insomnia (CBT-I): A systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it

159 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Erin KoffelCenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA. Erin.Koffel@va.gov.
Adam D BramowethCenter for Health Equity Research and Promotion, Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Christi S UlmerDurham VA Health Services Research and Development, Durham, NC, USA.
Duke University · USMinneapolis VA Health Care System · USVA Pittsburgh Healthcare System · US

Funding

Implementation of Brief Treatments for Insomnia in Primary CareIK2HX001548 · VA · VETERANS HEALTH ADMINISTRATION · PI BRAMOWETH, ADAM DANIEL · 2018 to 2020
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6 · The paper itself

Abstract

The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review. Implementation research testing specific interventions to increase routine and sustained use of CBT-I was lacking. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. These findings are organized using a conceptual model to represent the many challenges inherent in providing guideline-concordant insomnia care. We conclude with an agenda for future implementation research to systematically address these challenges.

Indexed as

Health Services AccessibilityPatient Acceptance of Health CareCognitive Behavioral TherapyHumansPrimary Health CareSleep Initiation and Maintenance Disorderscognitive behavioral therapy for insomniaguidelinesimplementationinsomnia

Identifiers

PMID29619651
PMCPMC5975165
OpenAlexW2795657325

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.