Background: Cognitive behavioural therapy for insomnia (CBT-I) is an effective treatment for chronic insomnia that also improves non-sleep symptoms, such as mood and anxiety. Identifying sleep-specific variables that predict anxiety change after CBT-I treatment may support alternative strategies when people with generalized anxiety disorder (GAD) do not improve from standard GAD treatment. Aims: To investigate CBT-I on changes in anxiety and evaluate whether changes in sleep-specific variables predict anxiety outcomes. Methods: Seventy-two participants presenting with insomnia and GAD (GAD-I) completed four sessions of CBT-I. Participants completed daily diaries and self-report measures at baseline and post-treatment. Results: CBT-I in a co‐morbid GAD-I sample was associated with medium reductions in anxiety, and large reductions in insomnia severity. Subjective insomnia severity and tendencies to ruminate in response to fatigue predicted post-treatment anxiety change, in addition to younger age and lower baseline anxiety. Conclusions: The findings suggest that younger GAD-I participants with moderate anxiety symptoms may benefit most from the anxiety-relieving impact of CBT-I. Reducing perceived insomnia severity and the tendency to ruminate in response to fatigue may support reductions in anxiety in those with GAD-I.

中文翻译：

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认知行为疗法对失眠和广泛性焦虑症共病患者的抗焦虑作用

背景：失眠认知行为疗法（CBT-I）是治疗慢性失眠的有效方法，还可以改善情绪和焦虑等非睡眠症状。当广泛性焦虑症 (GAD) 患者没有从标准 GAD 治疗中得到改善时，识别预测 CBT-I 治疗后焦虑变化的睡眠特定变量可能会支持替代策略。目的：调查 CBT-I 对焦虑变化的影响，并评估睡眠特定变量的变化是否可以预测焦虑结果。方法：72 名患有失眠和广泛性焦虑症 (GAD-I) 的参与者完成了四次 CBT-I 课程。参与者在基线和治疗后完成每日日记和自我报告测量。结果：共病 GAD-I 样本中的 CBT-I 与焦虑程度中等程度减轻以及失眠严重程度大幅减轻有关。除了年龄较小和基线焦虑较低之外，主观失眠严重程度和对疲劳反应的沉思倾向也预测了治疗后焦虑的变化。结论：研究结果表明，具有中度焦虑症状的年轻 GAD-I 参与者可能从 CBT-I 的焦虑缓解效果中获益最多。降低感知的失眠严重程度和对疲劳的反应倾向可能有助于减少 GAD-I 患者的焦虑。