MacKinnon Anna L, Silang Katherine, Watts Dana, Kaur Jasleen, Freeman Makayla, Dewsnap Kyle, Keys Elizabeth, Madsen Joshua W, Giesbrecht Gerald F, Williamson Tyler, Metcalfe Amy, Campbell Tavis, Mrklas Kelly J, Tomfohr-Madsen Lianne M
Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.
CHU Sainte-Justine Research Center, Montréal, Québec, Canada.
J Clin Sleep Med. 2025 Feb 1;21(2):365-376. doi: 10.5664/jcsm.11396.
Insomnia and sleep problems are common in pregnancy and have potentially negative impacts on both parental and infant health. This study examined the Sleeping for Two adaptation of cognitive behavioral therapy for insomnia (CBT-I) in pregnancy.
A parallel (1:1) randomized controlled trial evaluated CBT-I ( = 32) compared to a treatment as usual waitlist ( = 32) among pregnant individuals from Alberta, Canada experiencing insomnia. Five weekly individual sessions of CBT-I pivoted from in-person delivery to telehealth due to the COVID-19 pandemic physical distancing regulations. Insomnia symptom severity (primary outcome), insomnia diagnosis by structured interview, self-reported sleep problems, as well as sleep parameters measured by diary and actigraphy were assessed pretreatment at 12-28 weeks gestation, 1-week posttreatment, and 6 months postpartum. Birth information (secondary outcomes) were collected via delivery record and parent report of infant sleep (exploratory outcome) was taken at 6 months postpartum.
Multilevel modeling using an intention-to-treat approach showed that CBT-I was associated with a decrease in insomnia symptoms and improved sleep quality across time compared to treatment as usual. The CBT-I group had fewer diagnoses of insomnia posttreatment, but the difference did not reach statistical significance until 6 months postpartum. Participants with worse sleep quality at baseline benefitted substantially more from CBT-I vs treatment as usual waitlist.
CBT-I delivered in pregnancy can reduce symptoms of insomnia and improve sleep quality, which could in turn minimize risk of negative consequences for birthing parent and infant health.
Registry: ClinicalTrials.gov; Name: Sleeping for Two: RCT of CBT-Insomnia in Pregnancy; URL: https://www.clinicaltrials.gov/study/NCT03301727; Identifier: NCT03918057.
MacKinnon AL, Silang K, Watts D, et al. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy. . 2025;21(2):365-376.
失眠和睡眠问题在孕期很常见，对产妇和婴儿的健康都可能产生负面影响。本研究探讨了针对孕期失眠的认知行为疗法（CBT-I）的“双人睡眠”适应性方案。
一项平行（1:1）随机对照试验评估了CBT-I（n = 32）与常规治疗等待名单（n = 32）对来自加拿大艾伯塔省的失眠孕妇的效果。由于COVID-19大流行期间的物理距离规定，CBT-I的五次每周一次的个体治疗从面对面改为远程医疗。在妊娠12 - 28周、治疗后1周和产后6个月进行治疗前评估，包括失眠症状严重程度（主要结局）、通过结构化访谈进行的失眠诊断、自我报告的睡眠问题，以及通过日记和活动记录仪测量的睡眠参数。通过分娩记录收集出生信息（次要结局），并在产后6个月获取父母报告的婴儿睡眠情况（探索性结局）。
采用意向性分析的多水平模型显示，与常规治疗相比，CBT-I在整个时间段内与失眠症状的减轻和睡眠质量的改善相关。CBT-I组治疗后失眠诊断较少，但直到产后6个月差异才达到统计学意义。与常规治疗等待名单相比，基线睡眠质量较差的参与者从CBT-I中获益更多。
孕期进行CBT-I可减轻失眠症状并改善睡眠质量，进而可能将对产妇和婴儿健康产生负面影响的风险降至最低。
注册机构：ClinicalTrials.gov；名称：双人睡眠：孕期CBT - 失眠的随机对照试验；网址：https://www.clinicaltrials.gov/study/NCT03301727；标识符：NCT03918057。
MacKinnon AL, Silang K, Watts D, et al. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy. [Journal name]. 2025;21(2):365 - 376.
