Brief CBT-I for Insomnia Comorbid with Social Phobia: A Case Study

Despite an obvious link between social anxiety and acute state of insomnia, chronic types of sleep disturbances in people with social phobia have so far received limited research/clinical attention. This case report aims to illustrate the possibility of rectifying sleep disturbances comorbid with social phobia, using a brief cognitive behaviour therapy for insomnia (CBT-I). Method: Treatment involved five sessions of CBT-I provided individually on a weekly basis. Major treatment components included psychoeducation, sleep restriction therapy, stimulus control and cognitive restructuring. Results: Treatment effects were assessed using sleep diary and questionnaires over the course of the treatment and at ∼9 month follow-up. The results were encouraging with all targeted sleep parameters demonstrating improvements thatmet dual criteria for clinical significance. The gains were well maintained even at∼9 months after treatment. These improvements in sleep were accompanied by a reduction in sleep-related anxiety and dysfunctional beliefs and attitudes about sleep. Whilst the patient also reported a corresponding improvement in daytime functioning and general anxiety, no gains were observed in depression and social anxiety. Conclusions: These findings highlight the potential benefits of incorporating brief CBT-I into existing treatments for social phobia and encourage further research on the intricate relationship between sleep, mood and social anxiety.