Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study finds cognitive behavior therapy more effective than sleeping pills for treating insomnia

28.09.2004


Benefits of non-drug techniques top most popular sleeping pill, Ambien



A study by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School has found cognitive behavioral therapy (CBT) is more effective than sleeping pills in treating chronic sleep-onset insomnia. The findings, which appear in the Sept. 27 issue of the Archives of Internal Medicine, show non-drug techniques yield better short and long-term results than the most widely prescribed sleeping pill, zolpidem, commonly known as Ambien. It is the first placebo-controlled trial to evaluate the separate and combined effects of CBT and pharmacological therapies in treating insomnia in young and middle-aged adults.

"Sleeping pills are the most frequent treatment for insomnia, yet, CBT techniques clearly were more successful in helping the majority of study participants to become normal sleepers. The pills were found to be only moderately effective compared to CBT and lost their effectiveness as soon as they were discontinued," said study leader Gregg Jacobs, Ph.D., insomnia specialist in the Sleep Disorders Center of BIDMC and an assistant professor of psychiatry at Harvard Medical School. "Our results suggest CBT should now be considered the first line treatment for insomnia, which is experienced on a nightly basis by one-third of the nation’s adult population," added Jacobs.


Insomnia affects more than 70 million Americans and is one of the most common complaints brought to physician’s offices. Those with the condition experience difficulty initiating or maintaining sleep, often resulting in impaired daytime functioning. In the National Sleep Foundation’s 2002 Sleep in America poll, 35 percent of all adults experienced symptoms every night, with 58 percent reporting insomnia at least a few nights per week.

For the study, researchers conducted a randomized, placebo-controlled clinical trial involving 63 young and middle-aged adults with chronic sleep-onset insomnia. Interventions included behavioral and relaxation techniques, pharmacotherapy (using Ambien), or combined therapy compared with placebo.

Researchers measured sleep twice during an eight week treatment period: at mid-treatment when pharmacotherapy subjects were still taking a nightly does of Ambien and at the end of the eight week treatment period when Ambien subjects gradually tapered their medication and then discontinued it entirely. The main outcome measure was sleep-onset latency as shown by patient diaries. Secondary measures included sleep efficiency and total time as derived from the diaries, objective measures of variables using objective sleep recordings, and an assessment of daytime functioning.

Amongst the findings, CBT and combination groups showed the greatest changes in sleep-onset latency at mid-treatment, both registering a 44 percent reduction. Pharmacotherapy subjects showed a modest 29 percent reduction in latency, followed by 10 percent for the placebo group. At the end of the eight-week treatment period, CBT and combination treatment yielded a 52 percent reduction on sleep-onset latency; these improvements were maintained at long-term follow-up.

The moderate improvements observed in the Ambien group at mid-treatment were not maintained after the drug was gradually tapered and then discontinued. In fact, by the end of the eight-week treatment phase, insomnia returned toward baseline levels and did not differ from the placebo group. CBT and combined therapy also produced the greatest improvements in sleep efficiency and number of normal sleepers by the end of treatment on measures of sleep onset latency and sleep efficiency. There was no advantage of combined therapy over CBT alone. No significant differences emerged amongst groups in total sleep time, though all exhibited increases. The results form the objective sleep recordings paralleled the sleep dairy results.

Despite the fact sleeping pills are the most frequently prescribed treatment for insomnia, and newer generation medications are being introduced to the U.S. market, they are not recommended for long-term treatment. This is due to numerous and well-documented side effects such as dependency. Prior studies also indicate that insomnia patients prefer non-drug approaches.

Study co-authors include Edward Franz Pace-Schott, PhD and Robert Stickgold, PhD, of the BIDMC department of psychiatry; Charles W. Otto, M.D., F.C.C.M, of Massachusetts General Hospital and Harvard Medical School.

This research was funded by grants from the National Institutes of Health.

Marty Querzoli | EurekAlert!
Further information:
http://www.bidmc.harvard.edu

More articles from Studies and Analyses:

nachricht Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

Staying in Shape

16.08.2018 | Life Sciences

Diving robots find Antarctic seas exhale surprising amounts of carbon dioxide in winter

16.08.2018 | Earth Sciences

Protein droplets keep neurons at the ready and immune system in balance

16.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>