|
 Previous clinical trials testing sleep drugs like temazepam (Restoril)
against placebo pills have found insomnia symptoms can improve even
when patients don’t get the real treatment, said senior study author
Dr. Ben Colagiuri of the University of Sydney in Australia. One
problem with using placebos in these trials, however, is that
sometimes simply taking part in a study can influence how people
perceive their symptoms, he said.
To solve this issue, Colagiuri and colleagues examined data from 13
previously published studies that assigned some insomnia patients to
receive a placebo they were led to believe was an active treatment
or to a control group that got no treatment.
Compared to participants who didn’t receive any treatment, those who
got placebos they believed were real treatments reported more
improvements in their ability to fall asleep, total amount of rest
and sleep quality, the analysis found.
“The comparison with no treatment means that we can be sure that the
improvement we observed was due to a genuine placebo effect, rather
than being an artifact of simply taking part in a trial,” Colagiuri
said by email. “The study provides new evidence that genuine placebo
effects exist for insomnia treatments.”
Combined, the studies used in the analysis had a total of 566
participants who either reported that they had insomnia or had the
condition diagnosed by a clinician.
It’s unclear exactly why the placebo might help some people feel
better rested, but it’s possible just the act of taking a pill eased
some anxiety that made it harder for people to fall asleep,
Colagiuri said. Some recent research in other conditions like
migraines and chronic pain suggests the placebos may help even when
people know they’re taking dummy pills, he added.
However, when researchers examined data on 103 participants who had
objective tests like sleep-phase monitoring to measure how quickly
patients fell asleep with a placebo or without treatment, they
didn’t find any significant difference between these groups.
[to top of second column] |
Beyond the small number of total participants, another limitation of
the current study is that researchers didn’t have objective
measurements of sleep quality or duration to compare placebos
against no treatment, the authors note in Sleep Medicine.
Still, the results make sense because insomnia is ultimately a
disorder of perception, said Patrick Finan, a psychiatry and
behavior researcher at Johns Hopkins University School of Medicine
in Baltimore.
For example, a person who reports typically getting only four hours
of sleep a night, for example, might not meet the criteria for
insomnia if they don’t feel like the lack of rest impairs their
mood, cognition or behavior, Finan, who wasn’t involved in the
study, said by email.
By contrast, a person who says they normally get seven hours a night
might still have insomnia if they feel like they the amount or
quality of sleep they get is inadequate and they also report daytime
impairments in work or home life that they attribute to a lack of
sleep, Finan added.
“The upshot is insomnia is shaped by expectation and perception, so
it is not surprising that placebos, which implicitly alter
expectation, are effective in improving perceptions of sleep,” Finan
said. “It is notable that the effects of placebos did not extend to
objective measures of sleep.”
SOURCE: http://bit.ly/2pG6feK Sleep Medicine, online April 3, 2017.
[© 2017 Thomson Reuters. All rights
reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
