Although cognitive behavioral therapy is an effective treatment for insomnia in the general population, it is not in the dialysis population who have “unique pathophysiologic considerations,” according to investigators. Insomnia affects half of patients on dialysis. It is tied with adverse cardiac and cerebrovascular events and appears difficult to treat.
For patients undergoing hemodialysis with chronic insomnia, the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) or trazodone does not differ from placebo.
Investigators observed no change in Insomnia Severity Index scores from baseline to weeks 7 and 25 with CBT-1, trazodone, or placebo, suggesting these insomnia treatment options are not effective for patients undergoing hemodialysis.