Sleep medicine · 2026
The impact of cognitive behavioral group therapy for anxiety on GAD related sleep disturbance during the perinatal period.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Barrett Emily N, Alamo Fabiana, Inness Briar E, Furtado Melissa, Stallwood Emma, Frey Benicio N, Green Sheryl M
Аннотация
BACKGROUND: Generalized anxiety disorder (GAD) is highly prevalent during the perinatal (pregnancy and postpartum) period. Sleep disturbance (SD), a core symptom of GAD, and a common difficulty during the perinatal period, has been overlooked as a specific treatment target This study examined (1) the efficacy of cognitive behavioral group therapy for perinatal anxiety (CBT-PA) in reducing SD among individuals with GAD, and (2) whether SD functions as a mechanism of treatment change.
METHODS: Perinatal participants (pregnant or ≤12 months postpartum) with GAD enrolled in a randomized trial (n = 63) or receiving routine care (n = 93) were included. SD, GAD, and depression were assessed at pre-treatment and one-week post-treatment. SD was measured with the Insomnia Severity Index (ISI). Linear models tested treatment effects, the Reliable Change Index identified reliable SD improvement (RCI ≤ -1.96), clinical thresholds defined meaningful change (≥8.4-point ISI reduction), and regressions examined cross-domain associations.
RESULTS: One-third of participants met the clinical threshold for moderate to severe SD at baseline (ISI >15). CBT-PA reduced SD, with 26.8% showing reliable improvement and 15.3% achieving clinically meaningful change. Changes in sleep and anxiety were mutually predictive, with greater improvement in one associated with greater improvement in the other.
CONCLUSION: Perinatal individuals with GAD reported high levels of SD, which were associated with greater anxiety severity. CBT-PA was associated with reduced sleep disturbance for a subset of participants, and sleep and anxiety symptoms showed bidirectional change. These findings suggest sleep disturbance is an important GAD treatment target that may require focused intervention within perinatal psychological care.
METHODS: Perinatal participants (pregnant or ≤12 months postpartum) with GAD enrolled in a randomized trial (n = 63) or receiving routine care (n = 93) were included. SD, GAD, and depression were assessed at pre-treatment and one-week post-treatment. SD was measured with the Insomnia Severity Index (ISI). Linear models tested treatment effects, the Reliable Change Index identified reliable SD improvement (RCI ≤ -1.96), clinical thresholds defined meaningful change (≥8.4-point ISI reduction), and regressions examined cross-domain associations.
RESULTS: One-third of participants met the clinical threshold for moderate to severe SD at baseline (ISI >15). CBT-PA reduced SD, with 26.8% showing reliable improvement and 15.3% achieving clinically meaningful change. Changes in sleep and anxiety were mutually predictive, with greater improvement in one associated with greater improvement in the other.
CONCLUSION: Perinatal individuals with GAD reported high levels of SD, which were associated with greater anxiety severity. CBT-PA was associated with reduced sleep disturbance for a subset of participants, and sleep and anxiety symptoms showed bidirectional change. These findings suggest sleep disturbance is an important GAD treatment target that may require focused intervention within perinatal psychological care.