Ruifeng Cui

Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Amy Fiske

Committee Co-Chair

Amy Fiske

Committee Member

Daniel W McNeil

Committee Member

Nicholas Turiano


Rates of Insomnia Disorder have been found to be as high as 10% in the general population. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment for insomnia. Problematically, low rates of treatment attendance and adherence are common in CBT-I and negatively impact treatment outcomes. The present study examined predictors of attendance and adherence in a sample of adults receiving CBT-I. Identifying common predictors may help researchers in designing more effective CBT-I treatments. Participants were 108 community dwelling adults aged 19-95 who met criteria for Insomnia Disorder. The sample was comprised of primarily female (71.3%) middle age ( M = 50.5, SD = 14.6), Caucasian (92.6%) adults. Younger adults and adults with greater depression and anxiety symptoms were less likely to attend three or more sessions or complete CBT-I treatment. Additionally, younger adults were less likely to adhere to a consistent bed time and wake time, i.e., younger adults had greater variation in when they first went to bed at night and got out of bed in the morning. The present study found that younger adults and those with greater comorbid psychiatric symptom severity (i.e., depression and anxiety symptoms) were less likely to attend CBT-I treatment. Further, among patients who attended CBT-I treatment, younger adults were less likely to adhere consistently to a recommended bed time and wake time. Assessing for and addressing elevated depression and anxiety levels prior to CBT-I treatment may facilitate treatment attendance. Future research may investigate mediators of the relationship between age and CBT-I treatment utilization.