Effectiveness of the unified protocol in insomnia comorbid with anxiety disorders: case series report

Abstract

Introduction: Insomnia is the sleep disorder with the greatest comorbidity with emotional disorders and its diagnosis and treatment is considered of relevance to public health. Specific psychological treatments do not address both disorders, which translates into greater time and cost for the patient. As an alternative, transdiagnostic treatments have been recently developed and tested. These treatments are focused on identifying common mechanisms associated with the etiology and maintenance of different disorders (e.g., neuroticism, rumination or avoidance). The unified protocol for the transdiagnostic treatment of emotional disorders (UP) is a cognitive-behavioral intervention that has shown broad adaptability to various comorbid conditions such as insomnia and anxiety disorders. Objective: to evaluate the effect of the UP on insomnia and comorbid anxiety symptoms in a sample of Mexican adult patients (N=6). Method: A non-controlled quantitative pilot study was carried out with a within-subject design with pre- and post-treatment measurements as well as visual inspection of the results. The variables assessed were quality ( ICSP) and severity (ISI) of the sleep, sleep diary, insomnia (ESE), and anxiety symptoms (GAD-7). For the analysis of results, the Reliable Change Index (RCI) was calculated. Results: a decrease was observed in the scores of the 6 participants in the ICSP, ISI, ESE and GAD-7 consistent with the changes reported in the sleep diary. The RCI calculations achieve reliability in 5 of the 6 participants. Conclusion: based on these results we can say that the intervention was clinically significant for the participants, however, research needs to be done with a controlled research designs, larger number of participants, measuring the transdiagnostic mechanisms, and using polysomnography measures that allow these findings to be generalized.