Impacto da terapia cognitivo-comportamental no manejo da insônia crônica

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Maria Clara Tavares Fortuna
Mariana Morais Farina
Thallita Pereira de Pina
Pedro Henrique Dutra Morais Lião
Milena de Campos Miranda
Raíssa Mendes Guimarães
Joaquim da Silva Guimarães
João Gabriel Inácio dos Santos
Thiago Carvalho Barreto
Marcela de Andrade Silvestre

Resumo

Objetivo: Investigar os efeitos da terapia cognitivo-comportamental no manejo da insônia crônica, com foco na melhora da qualidade do sono e redução dos sintomas associados. Métodos: Trata-se de uma revisão integrativa da literatura realizadas através de buscas nas bases de dados PubMED, Periódico CAPES e BVS, utilizando os descritores “​​Cognitive Behavioral Therapy”, “Health Impact” e ”Chronic Insomnia”, em conjunto com o operador booleano “AND”. Foram selecionados 19 artigos que iam de encontro com o objetivo da pesquisa. Resultados: A insônia crônica afeta uma grande parte da população, comprometendo a qualidade de vida e a saúde mental. A terapia cognitivo-comportamental para insônia (TCC-I) tem se destacado como uma alternativa não farmacológica eficaz, reduzindo sintomas e melhorando o sono, sendo que suas versões digitais vêm sendo estudadas como alternativas viáveis, oferecendo resultados promissores. Os estudos mostraram redução de até 50% na gravidade da insônia, melhorias na qualidade do sono e diminuição do uso de medicações. A TCC-I é eficaz, mas enfrenta desafios de acesso e escassez de terapeutas. Considerações finais: A revisão evidenciou a eficácia da TCC-I no tratamento da insônia crônica, superando abordagens farmacológicas, e destacou estratégias como adaptação cultural e plataformas digitais para ampliar seu impacto.

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Como Citar
FortunaM. C. T., FarinaM. M., PinaT. P. de, LiãoP. H. D. M., MirandaM. de C., GuimarãesR. M., GuimarãesJ. da S., SantosJ. G. I. dos, BarretoT. C., & SilvestreM. de A. (2025). Impacto da terapia cognitivo-comportamental no manejo da insônia crônica. Revista Eletrônica Acervo Médico, 25, e20163. https://doi.org/10.25248/reamed.e20163.2025
Seção
Revisão Bibliográfica

Referências

1. ALFONSSON S, et al. Digital cognitive-behavioral therapy for insomnia in patients with multiple sclerosis: A multiple baseline single-case pilot study. Sleep medicine, 2024; 124: 443–452.

2. ALIMORADI Z, et al. Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: A systematic review and meta-analysis. Sleep medicine reviews, 2022; 64(101646): 101646.

3. BRAMOWETH AD, et al. Insomnia and insomnia-related care in the Department of Veterans Affairs: An electronic health record analysis. International journal of environmental research and public health, 2021; 18(16): 8573.

4. CHENG P, et al. Digital cognitive behavioral therapy for insomnia promotes later health resilience during the coronavirus disease 19 (COVID-19) pandemic. Sleep, 2021; 44(4): 1-9.

5. CHENG P, et al. Improved resilience following digital cognitive behavioral therapy for insomnia protects against insomnia and depression one year later. Psychological medicine, 2023; 53(9): 3826–3836.

6. EL RAFIHI-FERREIRA R, et al. Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial. Revista brasileira de psiquiatria (São Paulo, Brasil: 1999), 2021; 43(5): 504–509.

7. HE J, et al. Efficacy of simplified-cognitive behavioral therapy for insomnia(S-CBTI) among female COVID-19 patients with insomnia symptom in Wuhan mobile cabin hospital. Sleep And Breathing, 2021; 25(4): 2213–2219.

8. HINRICHSEN GA e LEIPZIG RM. Efficacy of cognitive behavioral therapy for insomnia in geriatric primary care patients. Journal of the American Geriatrics Society, 2021; 69(10): 2993–2995.

9. ITO-MASUI A, et al. Effect of an internet-delivered cognitive behavioral therapy-based sleep improvement app for shift workers at high risk of sleep disorder: Single-arm, nonrandomized trial. Journal of medical internet research, 2023; 25: 45834.

10. KIM WJ e KIM HS. Emerging and upcoming therapies in insomnia. Translational and clinical pharmacology, 2024; 32(1): 1–17.

11. KYLE SD, et al. The effects of digital cognitive behavioral therapy for insomnia on cognitive function: a randomized controlled trial. Sleep, 2020; 43(9): 1-12.

12. LIU CY, et al. Acupuncture combined with traditional Chinese medicine e-aid cognitive behavioral therapy for insomnia (TCM-eCBT-I) for chronic insomnia: study protocol for a randomized controlled trial. Trials, 2022; 23(1): 86.

13. MANBER R, et al. Perspectives on increasing the impact and reach of CBT-I. Sleep, 2023; 46(12): 1-7.

14. MILLER MB, et al. Cannabis use as a moderator of cognitive behavioral therapy for insomnia. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2022; 18(4): 1047–1054.

15. OCK S, et al. Cognitive behavioral therapy for treatment of insomnia in primary care for resident physicians. Med Ed PORTAL: the journal of teaching and learning resources, 2020; 16(1): 11002.

16. RITTERBAND LM, et al. Real-world evidence from users of a behavioral digital therapeutic for chronic insomnia. Behaviour research and therapy, 2022; 153(104084): 104084.

17. SPINA MA, et al. Cognitive behavioural therapy for insomnia reduces actigraphy and diary measured sleep discrepancy for individuals with comorbid insomnia and major depressive disorder: A report from the TRIAD study. Sleep medicine, 2024; 114: 137–144.

18. SWEETMAN A, et al. Effect of depression, anxiety, and stress symptoms on response to cognitive behavioral therapy for insomnia in patients with comorbid insomnia and sleep apnea: a randomized controlled trial. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2021; 17(3): 545–554.

19. THORNDIKE FP, et al. Effect of a prescription digital therapeutic for chronic insomnia on post-treatment insomnia severity, depression, and anxiety symptoms: results from the real-world DREAM study. Frontiers in psychiatry, 2024; 15: 1450615.

20. TU AY, et al. A randomized controlled trial of cognitive behavioral therapy for insomnia and PAP for obstructive sleep apnea and comorbid insomnia: effects on nocturnal sleep and daytime performance. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2022; 18(3): 789–800.

21. VEGA-ESCAÑO J, et al. Insomnia interventions in the workplace: A systematic review and meta-analysis. International journal of environmental research and public health, 2020; 17(17): 6401.

22. VESTERGAARD CL, et al. The effect of sleep-wake intraindividual variability in digital cognitive behavioral therapy for insomnia: a mediation analysis of a large-scale RCT. Sleep, 2021; 44(10): 1-10.

23. VGONTZAS AN, et al. Effects of trazodone versus cognitive behavioral therapy in the insomnia with short sleep duration phenotype: a preliminary study. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2020; 16(12): 2009–2019.

24. WALKER J, et al. Cognitive Behavioral Therapy for insomnia (CBT-I): A primer. Clinical Psychology and Special Education, 2022; 11(2): 123–137.

25. ZANDIEH S, et al. Therapist-guided remote versus in-person cognitive behavioural therapy: a systematic review and meta-analysis of randomized controlled trials. journal de l’Association medicale canadienne [Canadian Medical Association journal], 2024; 196(10): 327–340.