Electrophysiologic Changes in Blacks Treated With CBT for Insomnia

Insomnia is a highly prevalent, often debilitating, and economically burdensome condition.
Reviews of the literature indicate that there are ethnic differences in sleep behavior, with
African Americans objectively and subjectively reporting more disordered sleep than Caucasian
Americans.Chronic insomnia can have a significant impact on mental and physical health
outcomes and has been associated with impaired cognitive performance, particularly, in areas
of speed, attention, working memory, and executive function. In order to understand the brain
mechanisms in sleep disorder both during resting state as well as during cognitive
processing, the investigators will assess resting state EEG (during eyes-closed and eyes-open
conditions) as well as ERP tasks for assessing decision-making and reward processing. The
primary objective of the study is to evaluate the effect of a tailored, telephone-delivered
cognitive behavioral intervention, versus a self- monitoring control condition, on symptoms
of insomnia and its neurodynamic correlates.

Hypotheses: Among Blacks subjectively reporting symptoms of insomnia, those randomized to the
tailored, telephone-delivered CBT-I, compared with those randomized to the self-monitoring
control group, will have: Hyp. 1: Greater reduction in symptoms of insomnia as measured by
the Pittsburgh Sleep Quality Index. Hyp. 2: Greater neurophysiologic improvement (ERP, ERO)
in the intervention condition in response to laboratory paradigms Hyp 3: Greater improvement
in psychosocial functioning including reduction in depression and increase in quality of
life.