Efficacy of cognitive behavioral therapy with or without metacognitive techniques on sleep efficiency and perceived social support in people with chronic insomnia disorder

Background: Cognitive behavioral therapy is the first-line and golden standard in treating chronic insomnia disorder but some studies showed that by addressing metacognitive components, its efficacy increases. The present study aimed to evaluate efficacy of cognitive behavioral therapy with or without metacognitive techniques in people with chronic insomnia disorder. Materials and Methods: Once evaluator took diagnostic assessments, four patients including one male and three females who met eligibility criteria were assigned to cognitive behavioral therapy and cognitive behavioral therapy with metacognitive techniques consisting of detached mindfulness and worry/ rumination postponement. All of the patients were assessed six times by sleep efficacy index and perceived social support scale. Then, dada were analyzed by visual interpretation of ups and downs in graphs, effect size and diagnostic recovery. Results: Although duration of the disorder in patients who received cognitive behavioral therapy with metacognitive techniques was longer compared to patients in the other group, they had higher sleep efficiency and perceived social support than the other group. Both of the groups especially which received metacognitive techniques were achieved high effect size and diagnostic recovery. Treatment gains were maintained till three months after treatment ended. Conclusion: Adding metacognitive techniques to golden standard in treating of chronic insomnia disorder could increase the efficacy of cognitive behavioral therapy in terms of sleep efficiency and perceived social support.