Cognitive Behavioral Therapy for Insomnia and Depression Among Menopausal Women

Inclusion criteria

• Women with depression (BDI-II score of 14-63)
• Women aged between 40 and 55 years old, menopausal (12 consecutive months without menses)
• Women are willing to provide written informed consent to participate in the study.
• Women who have the ability to read and write Arabic language.
• Women who report wake after sleep onset (wakefulness in the middle of the night after falling asleep) of an hour or more on ≥ 3 nights per week and met criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (American Psychiatric Association, 2013) insomnia disorder with onset or exacerbation during the peri- or postmenopausal period per clinical interview with the researcher.
• Women who have a total score of >5 on the Pittsburgh Sleep Quality Index (PSQI), which indicates poor sleep, and a total score of >7 on the Insomnia Severity Index (ISI), which indicates insomnia.

Exclusion criteria

• Women who are currently under any type of psychotherapy or have a previous experience of Cognitive Behavioral Therapy.
• Women who have a history of neuropsychiatric illness, cancer, chemotherapy, and sudden stress in the previous 6 months (due to unfortunate events in the family) or have a severe or uncontrolled physical illness.
• Women who are clearly diagnosed as having sleep disorders or obstructive sleep apnea and had taken sleeping medications.
• Women who are on hormonal replacement therapy or cancer therapy or drugs such as tricyclic antidepressants, selective serotonin reuptake inhibitors, sedatives, and other hormones; and those who had undergone hysterectomy with oophorectomy.