Cognitive Behavioral Therapy for Insomnia Slows Biological Aging

Cognitive Behavioral Therapy for Insomnia Slowed Biological Aging

Older adults who completed cognitive behavioral therapy for insomnia experienced a measurable reduction in the pace of biological aging compared to peers who received sleep education. University of California, Los Angeles (UCLA) Health researchers published these findings from a randomized controlled trial in The Lancet Healthy Longevity.

Lead investigator Dr. Judith Carroll evaluated whether treating clinical sleep disruption could alter physiological decline. Between 10 percent and 25 percent of adults older than 65 in the United States have clinical insomnia.

How the Randomized Trial Tested Epigenetic Clocks

Researchers enrolled nearly 100 older adults with insomnia and assigned them to either cognitive behavioral therapy for insomnia (CBT-I) or sleep education therapy. The CBT-I protocol provided structured interventions targeting thoughts and behaviors that disrupt sleep across multiple sessions with a trained clinician. In contrast, the control group received sleep education that delivered general sleep hygiene information without behavioral strategies.

Staff drew blood samples before the eight-week treatment period began and repeated collections during follow-up visits over the subsequent two years. Technicians extracted deoxyribonucleic acid (DNA) to track cellular aging across three epigenetic calculators: DunedinPACE, GrimAge, and PC-PhenoAge.

Epigenetic Measurements and Insomnia Remission

Adults assigned to cognitive behavioral therapy achieved nearly three times the likelihood of insomnia remission compared to those in sleep education therapy. Epigenetic tracking showed that the behavioral therapy group experienced a significantly slower pace of biological aging on the DunedinPACE clock.

Prior research links chronic insomnia to accelerated DNA methylation, a cellular process that alters gene expression. Those epigenetic changes correlate with higher risks of age-related conditions, including cardiovascular disease, diabetes, and mortality.

Study Caveats and Next Research Directions

The trial enrolled participants exclusively from a single research site in Los Angeles, which constrains the broad applicability of the conclusions. The study authors noted that larger multi-site studies with participants representing diverse age groups, races, and ethnicities are needed to confirm the outcomes.

Further trials must examine whether treatment response varies by sex. Researchers also need to evaluate whether other interventions for insomnia, including medication or Tai Chi, produce similar biological aging effects.