Publications by authors named "K D Josephson"
Article Synopsis
- Placebo effects are often seen in clinical trials for benzodiazepine receptor agonists, leading to recommendations for discontinuation of these medications in older adults and the use of cognitive behavioral therapy for insomnia (CBTI) instead.
- This study aims to compare the effects of a masked tapering process combined with enhanced CBTI against standard CBTI with an unmasked taper in helping older adults discontinue benzodiazepine receptor agonists.
- The primary outcome measured is the percentage of participants successfully discontinuing their medication after 6 months, with additional assessments of insomnia severity and short-term discontinuation rates.
Background: Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard treatment for insomnia disorder in adults. Compared to young adults, older adults have increased risk for the development of conditions associated with chronic pain, which may impact the efficacy of CBT-I in improving insomnia symptoms in older adults. This study evaluated the effect of participant-rated pain on sleep-related outcomes of a supervised, non-clinician administered CBT-I program in older adult patients with chronic insomnia disorder.
View Article and Find Full Text PDFObjectives: Insomnia may contribute to fewer value-consistent choices and less engagement in meaningful life activities. We sought to identify values commonly expressed by women veterans engaged in a trial testing psychological treatment of insomnia disorder.
Methods: Seventy-four women veterans (mean age = 48.
Novel treatment based on acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized comparative effectiveness trial in women veterans.
J Consult Clin Psychol
November 2023
Objective: This randomized comparative effectiveness trial evaluated a novel insomnia treatment using acceptance and commitment therapy (ACT) among women veterans. Participants received either the acceptance and the behavioral changes to treat insomnia (ABC-I) or cognitive behavioral therapy for insomnia (CBT-I). The primary objectives were to determine whether ABC-I was noninferior to CBT-I in improving sleep and to test whether ABC-I resulted in higher treatment completion and adherence versus CBT-I.
View Article and Find Full Text PDFBackground: Obstructive sleep apnea (OSA) is highly prevalent in patients with Type 2 diabetes, more so in veterans compared with nonveterans. Positive airway pressure is the recommended first-line treatment for OSA. However, adherence to both positive airway pressure and diabetes management regimens can be challenging for older adults.
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