Preventing cardiovascular diseases in insomnia patients through CBT‐I?

Objectives/Instruction: Insomnia, cardiovascular disease (CVD) and hypertension are linked with each other in various ways. Insomnia is a risk factor for CVD (Sofi et al. 2014), sleep continuity disturbances are associated with an increased risk for hypertension (Meng et al. 2013), and hypertension is again a risk factor for CVD. So far, no studies have investigated the preventive effect of insomnia treatment on CVD. Thus, this study investigated the preventive effect of cognitive behavioural therapy for insomnia (CBT‐I), the first‐line treatment for insomnia, on hypertension. In detail, we investigated whether CBT‐I reduces blood pressure in insomnia patients. Methods: Forty‐six patients (17 males, 29 females; 41.0 ± 14.5 years) diagnosed with insomnia according to DSM‐5 criteria took part in a clinical trial at the Clinic for Psychiatry and Psychotherapy in Freiburg (Germany) between 2015 and 2017. After baseline measurement patients were randomized into either the treatment group or the waiting list control group. The intervention consisted of weekly individual sessions of CBT‐I over 8 weeks. Baseline‐ and post‐treatment measurement included 24h blood pressure measurement and assessment of sleep using the Insomnia Severity Index. Group differences were analysed using a two‐way ANOVA with the between‐subject factor group (treatment vs. waiting list) and the within‐subject factor time (baseline vs. post). Results: The interaction effect group × time was neither significant for systolic blood pressure (F(1,42) = 0.02, p = 0.901) nor for diastolic blood pressure (F(1,42) = 2.27, p = 0.139) indicating that there was no effect of CBT‐I on blood pressure. Regarding insomnia severity, we found that there was a significant group × time interaction in so far as symptom improvement was larger in the treatment group compared to the waiting list group (F = 31.34; p < 0.001). Conclusions: Results indicate that CBT‐I, though improving the severity of insomnia, does not have an effect on blood pressure. Future studies should investigate if other treatments have an impact on blood pressure to reduce the risk of CVD in insomnia patients. Disclosure: Nothing to disclose.