Cognitive behavioral therapy may reduce biological aging among older adults with insomnia
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In a new study published in The Lancet Healthy Longevity, UCLA Health researchers found that older adults who underwent cognitive behavioral therapy for insomnia were more likely to experience insomnia remission and a slower pace of biological aging than a control group that received sleep education.
"Insomnia in older adults is often treated as a quality-of-life issue, but these findings suggest it may also be a modifiable risk factor for how the body ages," said the study's lead author, Dr. Judith Carroll, an associate professor of psychiatry at UCLA Health.
"Just as we counsel patients on physical activity and diet to support healthy aging, this points to sleep as another important behavior worth targeting to improve health."
Between 10% and 25% of adults older than 65 in the U.S. have clinical insomnia. Previous studies have shown an association between insomnia and advanced biological aging, as measured by changes in DNA methylation, a process by which genes are turned on or off. This, in turn, is associated with a greater risk of age-related diseases, including cardiovascular disease and diabetes, as well as mortality.
How the trial compared treatments
In the new randomized controlled clinical trial, nearly 100 older adults with insomnia were assigned to one of two treatments: cognitive behavioral therapy for insomnia or sleep education therapy.
Cognitive behavioral therapy for insomnia involves structured treatment meant to target thoughts and behaviors that perpetuate insomnia, usually performed over multiple sessions with a trained clinician. By contrast, sleep education therapy includes general informational content about sleep and healthy sleep habits without behavioral techniques.
Blood was drawn before the eight-week treatment began and again at follow-up visits during the next two years. Researchers used the blood samples to extract DNA and test for biological aging using three aging calculators, also known as epigenetic clocks: DunedinPACE, GrimAge and PC-PhenoAge.
Remission rose as aging slowed
Carroll and her research team found that adults who underwent cognitive behavioral therapy had a nearly threefold greater likelihood of insomnia remission than those who received sleep education therapy. In addition, insomnia treatment significantly slowed the pace of aging based on the DunedinPACE epigenetic clock.
The authors noted several limitations, including that participants were from a single site in Los Angeles. A larger, multisite study with more diverse participants in age, ethnicity and race is needed to further verify the results. Additionally, the authors said more research is needed to determine whether treatment response differs by sex or whether other insomnia treatment options, such as medication or Tai Chi, could generate similar effects on aging.
Publication details
Judith E Carroll et al, Cognitive behavioural therapy for insomnia and epigenetic ageing: secondary analysis from a randomised controlled trial, The Lancet Healthy Longevity (2026). DOI: 10.1016/j.lanhl.2026.100861
Journal information: The Lancet
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Sleep medicinePsychiatryHealthy agingSleep & Recovery Provided by University of California, Los Angeles Who's behind this story?
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