Effectiveness of cognitive behavioural therapy for insomnia (CBT-I) in individuals with neurodevelopmental conditions : a systematic review

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Cullen, Maja and McCrory, Stephanie and Hooman, Gemma and Coyle, Megan and Fleming, Leanne (2025) Effectiveness of cognitive behavioural therapy for insomnia (CBT-I) in individuals with neurodevelopmental conditions : a systematic review. Journal of Sleep Research. ISSN 0962-1105 (In Press) (https://doi.org/10.1111/jsr.70058)

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Abstract

Cognitive Behavioural Therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia disorder in diverse populations with co-occurring conditions. However, individuals with neurodevelopmental conditions are frequently excluded from CBT-I research, despite high prevalence of sleep problems in this population. The present systematic review and narrative synthesis investigates the effectiveness of CBT-I in individuals with neurodevelopmental conditions. A literature search was completed in February 2024 across 5 databases. Of 1,988 unique entries, 8 studies from 5 countries met all inclusion criteria, amounting to a combined sample size of 598 participants (male = 75.92%, age range = 4 – 68). Five interventions were delivered to children and adolescents (M = 8.7 years ± 1.46), whilst 3 were delivered to adults (M = 35.78 years ± 5.71). All interventions included at least 2 CBT-I components but were diverse in content and format. Two randomised controlled trials and 6 before-after studies suggested significant short-term effectiveness of CBT-I in individuals with Autism Spectrum Disorder (ASD) and/or Attention-Deficit/Hyperactivity Disorder (ADHD). Improvements in severity of condition specific characteristics were observed in some studies. Still, findings were inconsistent and mostly not maintained at follow-up. Quality of included articles was moderate due to small sample sizes, lack of blinding, and deviations from the intended intervention. This variability may be explained by a lack of guidance on conducting CBT-I in this population. Hence, there is a need for further rigorous research and updated reviews to inform the implementation of CBT-I protocols for those with insomnia and neurodevelopmental conditions.

ORCID iDs

Cullen, Maja, McCrory, Stephanie ORCID logoORCID: https://orcid.org/0000-0002-8072-7482, Hooman, Gemma, Coyle, Megan and Fleming, Leanne ORCID logoORCID: https://orcid.org/0000-0001-6197-9214;
CORE (COnnecting REpositories)