CBT for Insomnia May Help Slow Biological Aging in Older Adults

The analysis focused on nearly 100 adults aged 60 and over with insomnia, who were part of a larger study with 291 participants. These individuals were randomly assigned to receive either CBT or sleep education therapy. CBT involves guided sessions with a clinician addressing thoughts and behaviors affecting sleep, while sleep education provides general information on healthy sleep habits without introducing specific behavioral techniques.

Blood tests conducted before the sleep education intervention and up to two years after showed significant increases in biological aging rates. However, participants receiving CBT for insomnia demonstrated a slower rate of biological aging, measured using the DunedinPACE clock—an epigenetic aging calculator linked to the risk of chronic diseases and overall mortality.

Judith Carroll, a psychoneuroimmunologist from the University of California, Los Angeles, stated, "To our knowledge, this is the first study to examine whether treating insomnia affects the pace of biological aging." She emphasized that addressing insomnia in older adults could offer a strategy for enhancing health in this vulnerable group.

CBT is recognized as a gold standard treatment for insomnia, often proving to be as effective as sleep medications but without side effects. Compared to pharmaceutical aids, CBT generally results in fewer relapses and sustained improvements post-treatment. Despite its benefits, CBT is frequently underused, possibly due to a lack of trained practitioners, familiarity with medication, or a preference for quicker solutions.

The study highlights that insomnia treatment should not only be seen as a quality-of-life issue but also as a potential modifiable risk factor for aging. Carroll pointed out that sleep should be targeted similarly to physical activity and diet for promoting health.

While the current study focused solely on older adults, further research is needed to explore insomnia's effects on younger populations, who may be more resilient to sleep loss. Nonetheless, existing evidence links insomnia in older individuals to various adverse health outcomes, including cognitive decline and higher risks of cardiovascular disease and mortality.

Prior analyses by some researchers at UCLA associate insomnia with biological aging indicators such as shorter telomere lengths. Notably, participants who achieved remission from insomnia through CBT showed significant reductions in a cellular aging marker, p16INK4a, while other groups either exhibited increases or no changes.

The underlying reasons for how sleep affects biological aging remain to be fully understood. It is proposed that good sleep may reduce inflammation and support metabolic processes, while chronic sleep deprivation may activate stress-response systems, potentially hastening aging due to increased inflammation and cellular stress.

The UCLA team concluded that treatment of insomnia in older adults should be considered an important clinical target to help slow biological aging and mitigate disease risk. In the United States, between 10 and 25 percent of adults over 65 are estimated to suffer from clinical insomnia. If widely adopted, CBT could improve the quality of life and possibly the longevity of millions. The research findings were published in The Lancet Healthy Longevity.