Cognitive behavioral therapy for insomnia may slow biological aging in older adults

A new UCLA Health study found that treatment of insomnia using cognitive behavioral therapy slowed the pace of biological aging in older adults.

In a new study published in The Lancet Healthy Longevity, UCLA Health researchers found that older adults who underwent cognitive behavioral therapy for insomnia were more likely to have insomnia remission and a slower pace of biological aging, as compared to responses in a control group who received sleep education.. 

"Insomnia in older adults is often treated as a quality-of-life issue, but these findings suggest it may also be a modifiable risk factor for how the body ages," said the study's lead author Dr. Judith Carroll, associate professor of psychiatry at UCLA Health. "Just as we counsel patients on physical activity and diet to support healthy aging, this points to sleep as another important behavior worth targeting to improve health."

Between 10-25% of adults over 65 in the U.S. have clinical insomnia. Previous studies have shown an association with insomnia and advanced biological aging as measured by changes in DNA methylation, a process by which genes are turned on or off. This in turn leads to a greater risk of age-related diseases, including cardiovascular disease and diabetes and mortality.

In the new randomized controlled clinical trial, nearly 100 older adults with insomnia were assigned one of two treatments: cognitive behavioral therapy for insomnia or sleep education therapy. Cognitive behavioral therapy for insomnia involves structured treatment meant to target thoughts and behaviors that perpetuate insomnia, usually performed over multiple sessions with a trained clinician. By contrast, sleep education therapy includes general, informational content about sleep and healthy sleep habits, without the behavioral techniques.

Blood was drawn before the 8-week treatment began and again at follow-up visits during the next two years. Researchers used the blood samples to extract DNA to test for biological aging using three aging calculators, also known as epigenetic clocks: DunedinPACE, GrimAge and PC-PhenoAge.

Carroll and her research team found that adults who underwent cognitive behavioral therapy had a nearly three-fold greater likelihood of insomnia remission compared to those who received sleep education therapy. In addition, insomnia treatment significantly slowed the pace of aging based on the DunedinPACE epigenetic clock.

The authors state that there are several limitations to the findings, including that the participants were from a single site in Los Angeles, California.. A larger, multisite study with more diverse participants in age, ethnicity, and race is needed to further verify the results. Additionally, the authors stated more research is needed to determine if there is any difference in treatment response based on sex or whether other insomnia treatment options, such as medication or Tai Chi, could generate similar effects on aging.