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Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial.

15 Aug

Researchers from Universite Laval in Quebec studied the relative effects of self-regulation therapies and pharmaceuticals on 78 adults with chronic and primary insomnia. Subjects were assigned to either Cognitive-Behavior Therapy (stimulus control, sleep restriction, sleep hygiene and cognitive therapy, N=18), pharmacotherapy (temazepam, N=20) or both (N=20), compared to a placebo group (N=20). The 3 active treatments were more effective than the placebo, and there was a trend for the combined approach to improve sleep more than either of its two single components. In fact, there was 63.5% greater reduction of time spent awake after sleep onset for the combined condition; 55% greater for the cognitive-behavior therapy condition; 46.5% greater for the pharmacotherapy condition; and 16.9% greater for the placebo condition. In addition, subjects trained in behavior therapy were more likely to sustain their clinical gains at follow-up, and reported greater satisfaction with treatment. The study concludes that behavioral and pharmacological approaches are both effective for the short term management of late life insomnia, but that sleep improvements are better sustained over time with behavioral therapies, and a combination might be best of all.

Citation: Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA 1999 March 17; 281 (11): 991-999.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award