Manualised CBT for insomnia delivered by nurse practitioners: results from studies conducted in primary care and in oncology

Aims : To summarise outcome data from three recent randomised clinical trials of CBT for insomnia, where nurse practitioners delivered the interventions Methods : Across three trials, two community-based and one based in oncology outpatient settings (secondary insomnia), a total of 490 adults with persistent insomnia were randomised either to CBT or treatment as usual (TAU). Health Visitors and Cancer Nurse Specialists were trained and supervised in the delivery of a validated, manualised therapy provided in small group format-the ‘Glasgow Model’. Results : CBT was associated with an average reduction in sleep-onset latency plus wake time after sleep onset of approximately 60 minutes per night of sleep, relative to little change in TAU. Demographic and clinical factors did not contraindicate response to this form of insomnia treatment. Conclusions : Clinical psychologists/ behavioural sleep medicine specialists have more to offer than direct clinical work. Insomnia assessment and treatment programme development, including the training and supervision of first-level CBT practitioners, offers one possible way forward.