The department of psychiatry of Amsterdam UMC, VUmc, has received 300,000 Euros from the Dutch Brain Foundation for the project “Overnight alleviation of anxiety”. Eus van Someren, Patricia van Oppen and Neeltje Batelaan are involved in this project, together with Annemieke van Straten (VU University). The Dutch Brain Foundation (Hersenstichting) has awarded 2 million Euros to 6 projects that investigate existing or new interventions on the neuropsychological consequences of brain disorders.
Mental disorders are highly burdening for individuals and society. 36% of the mental disorders concern what we transdiagnostically refer to as Anxiety and Stress Related Disorders (ASRD). ASRD frequently co-occur with insomnia disorder (ID).
Presence of insomnia gives a 17-fold increase in the odds of clinically relevant anxiety. We identified that good sleep is essential to recover from emotional distress. Unfortunately, the restless sleep characterizing ASRD and ID interferes with this recovery and instead promotes persistent hyperarousal. Adequate treatment of ID is thus important, but currently suboptimal. While patients prefer psychological treatment, they often develop dependency on benzodiazepines prescribed for symptom suppression: in 2017, Dutch pharmacies provided 161 million doses. Development of more effective treatments could benefit from a transdiagnostic approach.
ID improves significantly with Cognitive Behavioral Therapy for Insomnia (CBTI), which can also be provided through internet (I-CBTI) and is also effective for comorbid ID. For example, treatment of insomnia in major depressive disorder subsequently also mitigates depressive symptoms. CBTI has been shown effective in many disorders. Surprisingly, except for PTSD, to date there is not even a single study on the effect of CBTI on insomnia and anxiety symptoms in ASRD. Our project will address this gap. We will assess the efficacy of immediately applicable I-CBTI for improving both sleep and anxiety across various anxiety and stress related disorders.