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Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia—Results from a Randomized Interventional Study

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Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
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Department of Psychology, Bielefeld University, 33602 Bielefeld, Germany
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Department of Psychology, Faculty of Education, University of Isfahan, Isfahan 8174673441, Iran
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Psychiatric Clinics, Division of Substance Use Disorders Basel, University of Basel, 4055 Basel, Switzerland
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Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8008 Zürich, Switzerland
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Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
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Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
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Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
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Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
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School of Medicine, Tehran University of Medical Sciences, Tehran 1417466191, Iran
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Authors to whom correspondence should be addressed.
Life 2021, 11(2), 133; https://doi.org/10.3390/life11020133
Received: 7 January 2021 / Revised: 2 February 2021 / Accepted: 3 February 2021 / Published: 9 February 2021
(This article belongs to the Section Medical Research)
Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60–70 min) or to the active control condition (weekly group meetings for 60–70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia. View Full-Text
Keywords: insomnia; sleep quality; acceptance and commitment therapy; dysfunctional beliefs; sleep logs; experiential avoidance insomnia; sleep quality; acceptance and commitment therapy; dysfunctional beliefs; sleep logs; experiential avoidance
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MDPI and ACS Style

Zakiei, A.; Khazaie, H.; Rostampour, M.; Lemola, S.; Esmaeili, M.; Dürsteler, K.; Brühl, A.B.; Sadeghi-Bahmani, D.; Brand, S. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia—Results from a Randomized Interventional Study. Life 2021, 11, 133. https://doi.org/10.3390/life11020133

AMA Style

Zakiei A, Khazaie H, Rostampour M, Lemola S, Esmaeili M, Dürsteler K, Brühl AB, Sadeghi-Bahmani D, Brand S. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia—Results from a Randomized Interventional Study. Life. 2021; 11(2):133. https://doi.org/10.3390/life11020133

Chicago/Turabian Style

Zakiei, Ali, Habibolah Khazaie, Masoumeh Rostampour, Sakari Lemola, Maryam Esmaeili, Kenneth Dürsteler, Annette B. Brühl, Dena Sadeghi-Bahmani, and Serge Brand. 2021. "Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia—Results from a Randomized Interventional Study" Life 11, no. 2: 133. https://doi.org/10.3390/life11020133

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