Effects of cognitive-behavioural therapy for insomnia on cognitive and emotional functioning in adults with insomnia: behavioural and neuroimaging evidence
- 1Concordia University
Abstract
Study ObjectivesTo characterize neural correlates of memory and emotion reactivity in individuals with insomnia disorder (INS) compared to good sleepers (GS) and to investigate associated short- and long-term changes following cognitive-behavioural therapy for insomnia (CBTi).
MethodsThis randomized controlled trial included 56 INS and 20 GS. At baseline, participants underwent resting-state and task-based functional magnetic resonance imaging, including working memory, emotion reactivity, and face-name associative memory tasks. They filled out sleep diaries and self-report questionnaires about sleep, cognition, and emotions, and underwent in-lab polysomnography. Subsequently, participants with INS were randomized to either the 3-month treatment group (TX) or wait-list control group (WL). Both TX and WL groups repeated baseline assessments at three months post-randomization and completed sleep diaries and questionnaires one year after finishing CBTi.
ResultsAt baseline, the INS group reported higher insomnia severity, greater subjective cognitive impairment, and perceived sleep-related stimuli as more negative than GS. Contrasting with these subjective evaluations, no group differences were found in memory performance, task-based brain activity, or resting-state functional connectivity. At three months post-randomization and one-year follow-up, CBTi significantly improved subjective, but not objective, cognitive functioning and sleep in adults with INS. No significant treatment-related changes were observed in valence ratings of sleep images, task-based brain activity, or resting-state functional connectivity.
ConclusionsBeyond its primary role in improving insomnia symptoms, CBTi may have long-term benefits for individuals with INS who experience concerns about their cognitive functioning, even in the absence of objective changes in neural processing of cognitive and emotional tasks.
Clinical trialImpact of Insomnia Treatment on Brain Responses During Resting-state and Cognitive Tasks. ClinicalTrials.gov identifier: NCT04024787; https://clinicaltrials.gov/study/NCT04024787
Statement of SignificanceInsomnia disorder impairs sleep, cognitive, and emotional functioning, imposing a significant clinical burden and highlighting the need for effective interventions to address these impairments. Our study used self-reports, task performance, and neuroimaging techniques to comprehensively investigate the effectiveness of cognitive-behavioural therapy for insomnia on subjective and objective measures of sleep, cognitive, and emotional functions in adults with insomnia disorder. Our findings show that this treatment has long-lasting benefits on subjective, but not objective, cognitive functioning and sleep measures. No changes were found in valence ratings of sleep images, memory performance, or brain function. Future research should identify neural substrates and psychological processes underlying these subjective cognitive deficits as well as the dissociation between subjective and objective cognitive functioning in insomnia.
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BibTeX
@misc{gong2026effects,
title = {{Effects of cognitive-behavioural therapy for insomnia on cognitive and emotional functioning in adults with insomnia: behavioural and neuroimaging evidence}},
author = {K. Gong and E.-M. Phillips and A. A. Perrault and F. Borgetto and N. A. Walsh and M. Reyt and A. Maltezos and J. Garneau and L. Tarelli and J. J. McGrath and J. Savard and S. Schwartz and J.-P. Gouin and T. T. Dang-Vu},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.06.26364880},
url = {https://www.medrxiv.org/content/10.64898/2026.10.06.26364880v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Effects of cognitive-behavioural therapy for insomnia on cognitive and emotional functioning in adults with insomnia: behavioural and neuroimaging evidence
AU - K. Gong
AU - E.-M. Phillips
AU - A. A. Perrault
AU - F. Borgetto
AU - N. A. Walsh
AU - M. Reyt
AU - A. Maltezos
AU - J. Garneau
AU - L. Tarelli
AU - J. J. McGrath
AU - J. Savard
AU - S. Schwartz
AU - J.-P. Gouin
AU - T. T. Dang-Vu
PY - 2026
DA - 2026/10/06
PB - medRxiv
DO - 10.64898/2026.10.06.26364880
UR - https://www.medrxiv.org/content/10.64898/2026.10.06.26364880v1
AB - Study ObjectivesTo characterize neural correlates of memory and emotion reactivity in individuals with insomnia disorder (INS) compared to good sleepers (GS) and to investigate associated short- and long-term changes following cognitive-behavioural therapy for insomnia (CBTi). MethodsThis randomized controlled trial included 56 INS and 20 GS. At baseline, participants underwent resting-state and task-based functional magnetic resonance imaging, including working memory, emotion reactivity, and face-name associative memory tasks. They filled out sleep diaries and self-report questionnaires about sleep, cognition, and emotions, and underwent in-lab polysomnography. Subsequently, participants with INS were randomized to either the 3-month treatment group (TX) or wait-list control group (WL). Both TX and WL groups repeated baseline assessments at three months post-randomization and completed sleep diaries and questionnaires one year after finishing CBTi. ResultsAt baseline, the INS group reported higher insomnia severity, greater subjective cognitive impairment, and perceived sleep-related stimuli as more negative than GS. Contrasting with these subjective evaluations, no group differences were found in memory performance, task-based brain activity, or resting-state functional connectivity. At three months post-randomization and one-year follow-up, CBTi significantly improved subjective, but not objective, cognitive functioning and sleep in adults with INS. No significant treatment-related changes were observed in valence ratings of sleep images, task-based brain activity, or resting-state functional connectivity. ConclusionsBeyond its primary role in improving insomnia symptoms, CBTi may have long-term benefits for individuals with INS who experience concerns about their cognitive functioning, even in the absence of objective changes in neural processing of cognitive and emotional tasks. Clinical trialImpact of Insomnia Treatment on Brain Responses During Resting-state and Cognitive Tasks. ClinicalTrials.gov identifier: NCT04024787; https://clinicaltrials.gov/study/NCT04024787 Statement of SignificanceInsomnia disorder impairs sleep, cognitive, and emotional functioning, imposing a significant clinical burden and highlighting the need for effective interventions to address these impairments. Our study used self-reports, task performance, and neuroimaging techniques to comprehensively investigate the effectiveness of cognitive-behavioural therapy for insomnia on subjective and objective measures of sleep, cognitive, and emotional functions in adults with insomnia disorder. Our findings show that this treatment has long-lasting benefits on subjective, but not objective, cognitive functioning and sleep measures. No changes were found in valence ratings of sleep images, memory performance, or brain function. Future research should identify neural substrates and psychological processes underlying these subjective cognitive deficits as well as the dissociation between subjective and objective cognitive functioning in insomnia.
ER -