(PS11-33) Examining Improvements in Sleep Following Psychotherapy for Suicide Risk Overall, and as a Function of Brief Cognitive Behavioral Therapy Treatment

Abstract Text: Research shows that suicide risk can be perpetuated by sleep disturbances (i.e., difficulties falling and staying asleep). Brief Cognitive Behavioral Therapy (BCBT) is an evidence-based treatment proven to reduce subsequent suicide attempts by 60% compared to treatment as usual (TAU) that also specifically targets sleep disturbance. In a study of high-risk patients, those randomized to receive BCBT (but not TAU) reported a significant decrease in sleep disturbance symptoms over time. However, not all existing evidence-based treatments for suicide prevention specifically target sleep disturbances. Present Centered Therapy (PCT) is an evidence-based treatment that helps patients identify solutions to the current stressors and has been shown to reduce suicidal ideation. Between these two treatments, however, only BCBT includes a targeted sleep hygiene intervention adapted from cognitive behavioral therapy for insomnia. While extant literature has demonstrated BCBT as improving sleep disturbance when compared to TAU, no studies to date have demonstrated improvements in sleep disturbance when compared to other evidence-based treatments. The present study examined if participants randomized to BCBT demonstrated improvements in sleep disturbance over and above participants randomized to receive PCT. Participants included 64 adults experiencing recent suicidal thoughts or past suicidal behavior who were randomized to receive either BCBT or PCT. Both treatments were delivered via weekly, hour-long sessions, delivered via telehealth for a total of 12 sessions. Participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) measure of sleep disturbance at baseline, and 3- and 6-month follow-ups. We conducted Mixed-model RMANOVAs to examine changes in sleep disturbance scores over time as a function of treatment group, controlling for suicide attempt history. Sleep disturbance scores decreased significantly from baseline to 6-month follow-up (F(1, 61) = 6.40, p < .05, ηp2 = .10), indicating improvements in sleep that persisted in the months following treatment. Improvement in sleep did not vary across treatment groups, however (F(2, 61) = 0.25, p= .78, ηp2 = .004). These findings replicate and support previous findings demonstrating sleep disturbance reduced for those receiving BCBT. However, results did not support our hypothesis that BCBT reduced sleep disturbances significantly more than those randomized to the PCT condition. Findings suggest that participation in suicide focused treatments improves sleep regardless of if sleep is specifically targeted during treatment. Further research related to the influence of BCBT on subsequent sleep disturbance when compared to other treatments are warranted to investigate if sleep disturbance improves over time naturally, or if this was primarily driven by involvement in suicide-specific treatments