A pill-free route to better sleep for elderly

Elderly people suffering from insomnia may be better advised to seek help from cognitive behavioural therapy than sleeping pills, according to research published by Oxford and Bristol on Monday, 19 January 2004.

The team systematically examined scientific evidence to assess the effectiveness of cognitive behavioural treatments for insomnia for the over 60 year olds. Such treatment aims to improve sleep by changing poor sleeping habits and challenging negative thoughts, attitudes or beliefs about sleep. The researchers found that studies which were carried out in the most scientifically rigorous manner consistently reported improvements in maintaining good sleep for those who had cognitive behavioural therapy (CBT).

CBT to improve sleep includes teaching people good sleep habits, for example making sure that people reduce their caffeine intake after 4pm and that they prepare for rest properly in a number of ways. Another approach might be practicing some muscle relaxation skills, or getting people to have less sleep for a while and then gradually expanding it so that patients fall asleep more quickly. Helping people overcome their anxiety often associated with insomnia is another intervention that has been shown to be helpful.

Dr Paul Montgomery, Lecturer and Researcher at the Department of Social Policy and Social Work at Oxford University, said: ‘Older people are often prescribed a range of drugs for their health problems, many of which have side effects. Such side effects are just one reason why there is an argument to be made for clinical use of non-pharmacological treatments. Further research into which elements of cognitive behavioural therapy are most useful is needed. To increase the long-term effect, it may be necessary to do ‘top-up’ sessions at regular intervals. Cognitive behavioural therapy may also be useful in preventive education for sleep disorders.’

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