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 Researchers offered 160 adults with chronic insomnia six weeks of
treatment with cognitive behavioral therapy (CBT); half of them were
also randomly selected to take medication in addition to counseling.
At the end of this experiment, patients in both groups slept better,
but only the people who received therapy alone reported significant
reductions in how much sleep impacted their daytime functioning and
things like memory, concentration and quality of life as well as
declines in anxiety, depression and fatigue.
“Most individuals with insomnia seek treatment, not necessarily
because of the nocturnal insomnia symptoms, but when they start
experiencing the negative daytime consequences of these night time
sleep difficulties on their energy, mood, and mental abilities,”
said lead study author Charles Morin of Laval University in Quebec
City.
“Showing that cognitive behavior therapy improves not only sleep but
also daytime functioning and quality of life is thus very important
and should give hope to patients who have suffered chronic
insomnia,” Morin added by email.
One in three adults have occasional insomnia, and one in 10 are
chronic sufferers who routinely sleep less than 6.5 hours a night
for several months at a time, according to the American Sleep
Association.
Most people have insomnia as a result of physical or mental
illnesses, medication side effects, or from smoking or drinking too
much caffeine and alcohol. The condition becomes more common with
age, and typically affects more women than men. Stress, shift work
and frequent travel across time zones can make matters worse.
For the current study, researchers focused on adults with chronic
insomnia who were at least 30 years old.
All of the participants received six weekly 90-minute group therapy
sessions; the half also assigned to take drugs were prescribed
zolpidem (Ambien).
After this initial treatment for acute insomnia, people getting
therapy, with or without medication, were again randomly divided
into groups who would continue getting intermittent CBT over six
months or who got no further therapy sessions. Those who continued
getting therapy reported more additional improvement over the long
term than the people who stopped counseling after six weeks, the
study team reports in Behavior Research and Therapy.
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One limitation of the study is that researchers didn’t test the
effects of taking medication without cognitive behavioral therapy,
the authors note. This makes it impossible to determine whether
counseling on its own would be better than only using prescription
sleep aids.
Though the study didn’t look at safety, zolpidem has some side
effects including drowsiness, headaches, memory loss and suicidal
thoughts.
While the findings don’t suggest doctors should stop prescribing
sleep aids, the results do help to make a case for physicians to
consider cognitive behavioral therapy as a good first option for
some patients, said Patrick Finan, a researcher at Johns Hopkins
University School of Medicine in Baltimore.
“These findings suggest that cognitive behavior therapy alone is
better than cognitive behavior therapy plus zolpidem for daytime
symptoms,” Finan, who wasn’t involved in the study, said by email.
“It is generally preferable to employ as few interventions as
possible to achieve a desired effect,” Finan added. “These findings
support the notion that less is more.”
SOURCE: http://bit.ly/2e6oeYT Behavior Research Therapy, online
September 13, 2016.
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