Grant: Operating Grant

Insomnia is a very frequent medical problem affecting more than 10% of the population. Consequences of insomnia on quality of life and health are numerous, including low mood and irritability, increased suicide risk, increased risk for some medical diseases, and impaired work productivity. A psychological treatment called cognitive-behavioral therapy (CBT) has been successfully developed for chronic insomnia. While this treatment seems beneficial for a proportion of chronic insomnia patients, there is currently no effective way to identify which patients will be more likely to respond to CBT. Knowing in advance the potential response of insomniac patients to CBT will allow clinicians to propose more effective treatments to those patients who are less likely to benefit from CBT. Our objective is therefore to identify measures that will predict each person's response to CBT for insomnia. In particular, we will study how emotions are regulated in insomniac patients, in the brain (using brain imaging) and in the body (using autonomic nervous system measurement). Indeed, impairments in emotional regulation have been demonstrated in insomnia and could constitute key elements for how these patients respond to CBT. In this project, participants with chronic insomnia will have a comprehensive evaluation of their sleep in addition to the brain imaging and autonomic nervous system measurement. They will then receive a 6-week CBT treatment for insomnia, after which their sleep will be reevaluated. Measures of brain imaging and autonomic nervous system will then be analyzed to assess their relationship with changes in sleep quality following CBT. Predicting patients' response to CBT will allow insomniacs to receive the therapeutic option that is the most appropriate to their specific situation. The proposed project will therefore lead to the implementation of more effective therapeutic interventions for this highly prevalent public health concern.