0453 Feasibility and Preliminary Outcomes of Multidisciplinary CBTi + Exercise Program for Insomnia

Abstract Introduction Insomnia is a common sleep disorder with multifactorial origins. Cognitive Behavioral Therapy for Insomnia (CBTi) is the first-line treatment, yet adherence remains challenging. Physical activity may enhance engagement and outcomes. This study evaluated the feasibility and preliminary results of a multidisciplinary program integrating CBTi with home-based resistance exercise (RE). Methods Between April–October 2025, 77 participants (mean age 58.6 ± 12.9 years; 71.4% female) at Samsung Medical Center were randomized to CBTi + RE, CBTi only, or RE only. The CBTi program comprised four structured sessions over 1.5–2 months, including cognitive restructuring, anxiety reduction, and behavioral techniques (stimulus control, sleep restriction, relaxation, sleep hygiene). The RE program spanned 9 months in three phases, each with outpatient evaluations, remote guidance, and video-based progressive resistance training with stretching. Participants tracked progress via sleep and exercise diaries. Results Completion rates were highest in CBTi + RE (55%), followed by CBTi (53%) and RE (47%). Dropout was lowest in the integrated group (10%) compared to CBTi (42%) and RE (26%). While no participants in single-modality groups remained active, 29% of the integrated group continued participation. Because CBTi ended within 2.5 months and RE extended over 9 months, direct comparisons between CBTi + RE and CBTi alone were limited. Preliminary findings showed significant improvements in sleep efficiency (actigraphy/diaries), rising from 78.27 ± 11.08% to 86.24 ± 6.74% (t = 2.51, p = 0.023). PSQI scores improved significantly (t = –4.46, p 0.001), while ISI scores showed a non-significant reduction (t = –1.62, p = 0.126). Chair stand performance (30 sec) improved from 22.67 ± 5.28 to 26.33 ± 7.05 (t = 3.39, p = 0.006), indicating enhanced lower-body endurance. Conclusion The integrated CBTi + RE program demonstrated higher retention and completion rates than single-modality interventions, with significant gains in sleep quality and physical function. A combined cognitive-behavioral and physical approach may improve adherence and outcomes in insomnia treatment. Further results are expected upon completion of the 9-month RE schedule, particularly regarding sleep and mood. Support (if any)