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Behavioral Therapy Relieves Insomnia

For patients with persistent insomnia, a combination of cognitive behavior therapy (CBT) and the medication zolpidem improves sleep over a 6 week period. If the intervention extends for a longer period, CBT alone is more beneficial.

Insomnia is a prevalent public health problem affecting large segments of the population on a situational, recurrent, or chronic basis.

“Persistent insomnia is associated with significant impairments of daytime functioning, reduced quality of life, and when persistent insomnia is not treated, it heightens the risks for major depression and hypertension,” the authors write.

CBT and some sleep medications are effective for short-term treatment of insomnia, but few patients achieve complete remission with any single treatment. It has been unclear whether combined therapies would improve outcomes.

Charles M. Morin, Ph.D., of the Universite Laval, Quebec, Canada, and colleagues evaluated the short- and long-term effects of CBT, singly and combined with the medication zolpidem, for persistent insomnia, and compared treatment strategies to optimize long-term outcomes.

The trial included 160 adults, who were randomized to receive either CBT alone or CBT plus 10 mg/d (taken at bedtime) of zolpidem for an initial 6-week therapy, followed by extended 6-month therapy.

The CBT included recommendations on how to improve sleep and education regarding faulty beliefs and misconceptions about sleep.

The researchers found that CBT used singly or in combination with zolpidem produced significant improvements in the amount of time that it took to fall asleep, time awake after falling to sleep, and sleep efficiency during initial therapy.

A larger increase of sleep time was obtained with the combined approach. After six weeks, the proportion of patients who responded to treatment of CBT alone (60 percent) or CBT plus zolpidem (61 percent) were similar, as were treatment remissions (39 percent for the CBT alone group; 44 percent for the CBT plus zolpidem group).

“The best long-term outcome was obtained with patients treated with combined therapy initially, followed by CBT alone, as evidenced by higher remission rates at the six-month follow-up compared with patients who continued to take zolpidem during extended therapy (68 percent vs. 42 percent),” the authors write.

“Although the present findings are promising, there is currently no treatment that works for every patient with insomnia and additional studies are needed to develop treatment algorithms to guide practitioners in the clinical management of insomnia.”

The study is found in the current issue of JAMA.

Source: JAMA and Archives Journals

Behavioral Therapy Relieves Insomnia

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Behavioral Therapy Relieves Insomnia. Psych Central. Retrieved on August 16, 2018, from https://psychcentral.com/news/2009/05/20/behavioral-therapy-relieves-insomnia/5999.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.