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<p>Insomnia symptoms are common and have been associated with disrupted circadian rhythms, altered eating behaviors, and poorer diet quality. Cognitive Behavioral Therapy for Insomnia (CBTi) is recommended as a first-line treatment for insomnia, but its potential effects on diet quality and meal-timing behaviors remain underexplored. This pilot controlled trial evaluated the feasibility of a brief CBTi protocol and estimated its preliminary effects on sleep outcomes, with secondary exploratory assessment of diet quality and chrononutrition-related eating behaviors in adults with insomnia symptoms. Adults aged 18–65 years reporting insomnia symptoms were allocated to a four-session CBTi intervention (<i>n</i> = 10 completers) or a sleep hygiene control condition (<i>n</i> = 10 completers). Outcomes assessed pre- and post-intervention included one week of wrist actigraphy, the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), 7 days of 24-hour dietary recalls, WHO healthy-diet adherence, meal-timing variables, and the Emotional Eating Questionnaire (EEQ). Between-group post-intervention differences were assessed using ANCOVA models adjusted for the corresponding baseline value of each outcome. After baseline adjustment, CBTi was associated with significantly lower post-intervention wake after sleep onset compared with sleep hygiene (adjusted mean difference − 32.14&#xa0;min; 95% CI: −62.54 to − 1.73; <i>p</i> = 0.040). CBTi was also associated with significantly lower late-night eating frequency (adjusted mean difference − 0.56 episodes; 95% CI: −1.03 to − 0.10; <i>p</i> = 0.021). ESS scores were lower in the CBTi group but did not reach statistical significance after baseline adjustment (adjusted mean difference − 3.29; 95% CI: −6.92 to 0.35; <i>p</i> = 0.074). Other sleep, diet-quality, and dietary-adherence outcomes numerically favored CBTi but were not statistically significant. In this pilot trial, brief CBTi was feasible and associated with preliminary baseline-adjusted improvements in sleep continuity and late-night eating frequency compared with sleep hygiene. Given the small final sample, substantial attrition, and completer-only analysis, these findings should be interpreted as exploratory and hypothesis-generating. Future adequately powered trials are needed to confirm these findings and determine whether changes in sleep mediate changes in diet quality or meal timing.</p><p><b>Trial registration</b>: This trial was registered at ClinicalTrials.gov (Identifier: NCT06300684) on 2024-02-22. <a href="https://clinicaltrials.gov/study/NCT06300684">https://clinicaltrials.gov/study/NCT06300684</a>.</p>

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Effects of cognitive behavioral therapy for insomnia on sleep, diet quality, and meal timing in Lebanese adults: a pilot controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Farid Talih,
  • Chadi Antoun,
  • Mohamad Wehbe,
  • Ismat Annan,
  • Petra Nicolas,
  • Lama Mattar

摘要

Insomnia symptoms are common and have been associated with disrupted circadian rhythms, altered eating behaviors, and poorer diet quality. Cognitive Behavioral Therapy for Insomnia (CBTi) is recommended as a first-line treatment for insomnia, but its potential effects on diet quality and meal-timing behaviors remain underexplored. This pilot controlled trial evaluated the feasibility of a brief CBTi protocol and estimated its preliminary effects on sleep outcomes, with secondary exploratory assessment of diet quality and chrononutrition-related eating behaviors in adults with insomnia symptoms. Adults aged 18–65 years reporting insomnia symptoms were allocated to a four-session CBTi intervention (n = 10 completers) or a sleep hygiene control condition (n = 10 completers). Outcomes assessed pre- and post-intervention included one week of wrist actigraphy, the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), 7 days of 24-hour dietary recalls, WHO healthy-diet adherence, meal-timing variables, and the Emotional Eating Questionnaire (EEQ). Between-group post-intervention differences were assessed using ANCOVA models adjusted for the corresponding baseline value of each outcome. After baseline adjustment, CBTi was associated with significantly lower post-intervention wake after sleep onset compared with sleep hygiene (adjusted mean difference − 32.14 min; 95% CI: −62.54 to − 1.73; p = 0.040). CBTi was also associated with significantly lower late-night eating frequency (adjusted mean difference − 0.56 episodes; 95% CI: −1.03 to − 0.10; p = 0.021). ESS scores were lower in the CBTi group but did not reach statistical significance after baseline adjustment (adjusted mean difference − 3.29; 95% CI: −6.92 to 0.35; p = 0.074). Other sleep, diet-quality, and dietary-adherence outcomes numerically favored CBTi but were not statistically significant. In this pilot trial, brief CBTi was feasible and associated with preliminary baseline-adjusted improvements in sleep continuity and late-night eating frequency compared with sleep hygiene. Given the small final sample, substantial attrition, and completer-only analysis, these findings should be interpreted as exploratory and hypothesis-generating. Future adequately powered trials are needed to confirm these findings and determine whether changes in sleep mediate changes in diet quality or meal timing.

Trial registration: This trial was registered at ClinicalTrials.gov (Identifier: NCT06300684) on 2024-02-22. https://clinicaltrials.gov/study/NCT06300684.