Evidence map›Paper›PMID 40476601›Full record

Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2025

Comparative effectiveness and predictors of cognitive behavioral therapy for insomnia and its components in older adults: main outcomes of a randomized dismantling trial.

Kathleen P O'Hora, Allison B Morehouse, Leah Freidman, Donn Posner, Maryam Ahmadi, Beatriz Hernandez, Kristen Faye Burda, Clete Kushida, Jamie M Zeitzer, Laura C Lazzeroni and 3 more

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02117388 (Treatments for Insomnia), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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.

NCT02117388 nacompletednot on this map

Treatments for Insomnia: Mediators, Moderators and Quality of Life

TypeinterventionalSponsorPalo Alto Veterans Institute for ResearchRan2013 to 2019Enrolled128ConditionsInsomniaArmsSleep Restriction, Cognitive Behavioral Therapy, Combined Therapy
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Dismantling CBT-I components to understand mental health effects beyond insomnia. Comment to O'Hora et al.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Article
  4. Article
  5. Cognitive and behavioral therapies for insomnia: must they always be in bed together?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Article
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

13 authors.

Kathleen P O'HoraDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Allison B MorehouseDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Leah FreidmanMental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California.
Donn PosnerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Maryam AhmadiDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Beatriz HernandezDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Kristen Faye BurdaDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Clete KushidaMental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California.
Jamie M ZeitzerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Laura C LazzeroniDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Rachel ManberDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Jerome YesavageDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Andrea N Goldstein-PiekarskiDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.

Funding

Treatments for Insomnia, Mediators, Moderators, and Quality of LifeR01MH101468 · NIMH · PALO ALTO VETERANS INSTIT FOR RESEARCH · PI YESAVAGE, JEROME A · 2013 to 2017
$1.8M
NIMH NIH HHS R01 MH101468
6 · The paper itself

Abstract

STUDY

objectivesTo determine the relative effectiveness and predictors of cognitive therapy (CT), behavioral therapy (BT), and cognitive behavioral therapy (CBT) for insomnia in older adults.

methodsIn a registered clinical trial (NCT02117388), 128 older adults with insomnia disorder were randomly assigned to receive CBT, BT, or CT. Insomnia Severity Index (ISI) score was the primary outcome. Sleep diaries, fatigue, beliefs about sleep, cognitive arousal, and stress were secondary outcomes. Split-plot linear mixed models assessed within- and between-subject changes in outcomes among the treatments. As a secondary analysis, we used linear regression to test predictors of insomnia symptoms improvement, including sleep diary measures, cognitive arousal, stress, beliefs about sleep, baseline ISI score, and age. Benjamini-Hochberg correction was applied.

resultsAll groups exhibited insomnia symptom reduction at posttreatment (CT:

conclusionsCBT for insomnia and its components each independently result in significant improvements in self-reported insomnia symptoms, beliefs about sleep, worry, and fatigue in older adults. CLINICAL

trial registrationRegistry: ClinicalTrials.gov; Name: Treatments for Insomnia: Mediators, Moderators and Quality of Life; URL: https://clinicaltrials.gov/study/NCT02117388; Identifier: NCT02117388. CITATION: O'Hora KP, Morehouse AB, Freidman L, et al. Comparative effectiveness and predictors of cognitive behavioral therapy for insomnia and its components in older adults: main outcomes of a randomized dismantling trial.

Indexed as

Cognitive Behavioral TherapySleep Initiation and Maintenance DisordersAgedFemaleHumansMaleMiddle AgedSeverity of Illness IndexTreatment Outcomecognitive behavioral therapy for insomniainsomniaolder adultstime in bedwake after sleep onset

Identifiers

PMID40476601
PMCPMC12493071

What OpenQuestion holds

Textmetadata
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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.