Effect of Cognitive Behavioral Therapy for Insomnia on Stellate Ganglion Block Treatment for Chronic Insomnia

Background: Chronic insomnia is a prevalent health concern. Treatment methods for chronic insomnia encompass medication therapy, psychotherapy, physical therapy, and sympathetic nerve regulation therapy. The synergistic effects of these various therapeutic approaches warrant further investigation. Objective: This study aims to evaluate the impact of cognitive behavioral therapy for insomnia (CBT-I) in conjunction with stellate ganglion block (SGB) treatment on patients suffering from chronic insomnia. Patients and Methods: Patients diagnosed with chronic insomnia who were admitted to the anesthesia outpatient department between January 2023 and September 2024 were selected for this study. They were divided into two groups: the SGB group (Group S) and the CBT-I combined with SGB group (Group CS). Group S received ultrasound-guided SGB using 0.375% ropivacaine at a volume of 4 mL alternately on both sides, administered twice weekly over a period of 6 weeks. Group CS underwent CBT-I concurrently with SGB following the same protocol as Group S for 6 weeks. The Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and hypnotic medication were recorded before treatment as well as at 6 weeks and 12 weeks after treatment. Results: The ISI and ESS scores were significantly decreased than before treatment at 6 weeks after treatment in group S ( P < 0.05), and the ISI and ESS scores were significantly decreased than before treatment at 6 and 12 weeks after treatment in group CS ( P < 0.05). The ISI and ESS scores were significantly lower in group CS than in group S at 6 and 12 weeks after treatment ( P < 0.05). The hypnotic medication was also significantly lower in group CS than in group S at 12 weeks after treatment ( P < 0.05). Conclusion: CBT-I substantially enhances the efficacy of stellate ganglion block treatment for chronic insomnia, reducing reliance on hypnotic medications; furthermore, sustains stable long-term outcomes. Keywords: chronic insomnia, cognitive behavioral therapy, stellate ganglion block, hypnotic medication, effect