Evidence map›Paper›PMID 41678078›Full record

Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2026

Results of a pilot randomized controlled trial of CBT-I for veterans with serious mental illness and insomnia.

Elizabeth A Klingaman, Richard W Goldberg, Clayton H Brown, Lan Li, Julie A Kreyenbuhl, Philip R Gehrman, Mary Katherine Howell, Peter L Phalen, Melanie W Fischer, Melanie E Bennett

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Elizabeth A KlingamanMental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs (VA), Capitol Health Care Network (VISN 5), Baltimore, MD, USA. elizabeth.klingaman@va.gov.ORCID 0000-0002-4917-9553
Richard W GoldbergMental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs (VA), Capitol Health Care Network (VISN 5), Baltimore, MD, USA.
Clayton H BrownDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Lan LiDivision of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
Julie A KreyenbuhlMental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs (VA), Capitol Health Care Network (VISN 5), Baltimore, MD, USA.
Philip R GehrmanDepartment of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA.
Mary Katherine HowellMental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs (VA), Capitol Health Care Network (VISN 5), Baltimore, MD, USA.
Peter L PhalenDivision of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
Melanie W FischerVA Connecticut Health Care System, West Haven, CT, USA.
Melanie E BennettMental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs (VA), Capitol Health Care Network (VISN 5), Baltimore, MD, USA.

Funding

RRD VA IK2 RX001836U.S. Department of Veterans Affairs 1IK2RX001836
6 · The paper itself

Abstract

STUDY

objectivesFor Veterans living with a serious mental illness (SMI), insomnia is prevalent and harmful. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment, but Veterans with SMI experience significant environmental, psychological, and systemic barriers to receiving and benefiting from it. There is limited clinical guidance on using CBT-I with Veterans with SMI. We developed provider guidelines and patient materials for conducting CBT-I when these barriers are present for people with SMI (CBT-I for SMI) and evaluated the acceptability and preliminary efficacy of CBT-I for SMI in an assessor-blind randomized controlled trial.

methodsForty-seven Veterans with insomnia and SMI were randomized to either CBT-I for SMI (n = 26) or Health and Wellness (HW; n = 21), an active control condition. At baseline, post-treatment, and 3-month follow-up, participants completed: actigraphy and daily sleep diaries for two weeks and self-report measures of insomnia and functioning. At 3-month follow-up, participants completed satisfaction ratings of treatment.

resultsCBT-I for SMI participants had high treatment satisfaction and attendance. At post, compared to HW, CBT-I caused statistically significantly greater reductions in diary-measured time-in-bed, increases in diary-measured sleep efficiency, reductions in actigraphy-measured time-in-bed and total sleep time, and improvements in self-reported insomnia severity and sleep-related functioning; relative to CBT-I, HW improved community participation.

conclusionsCBT-I for SMI is acceptable to Veterans with SMI and improves sleep and functioning. Future research should examine how sleep mediates effective functional gains, identify how CBT-I could be integrated within recovery centers, and develop preventative interventions to curtail insomnia-associated functional decline. People with serious mental illnesses experience challenges to receiving and benefiting from Cognitive Behavioral Therapy for Insomnia. To support providers and patients, we developed guidelines and materials for navigating these challenges while conducting Cognitive Behavioral Therapy for Insomnia with people with serious mental illness. In the first study to compare Cognitive Behavioral Therapy for Insomnia conducted with our materials and guidelines to an active treatment control, we found that our guideline-led Cognitive Behavioral Therapy for Insomnia improved self-reported insomnia severity, sleep-related functioning, and actigraphy and diary-measured sleep of Veterans with serious mental illness and insomnia. Veterans with serious mental illness can participate in, derive satisfaction from, and benefit from Cognitive Behavioral Therapy for Insomnia when this treatment is appropriately tailored.

Indexed as

Cognitive Behavioral TherapyMental DisordersSleep Initiation and Maintenance DisordersVeteransActigraphyAdultFemaleHumansMaleMiddle AgedPilot ProjectsTreatment OutcomeBipolarInsomniaPsychosisSchizophreniaSerious mental illnessVeterans

Identifiers

PMID41678078
PMCPMC12977301

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.