title: Efficacy of two behavioral treatment programs for comorbid geriatric insomnia.
abstract: Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatment research, but recent evidence suggested that such treatments would be effective with this population. In this study, 38 older adults with comorbid insomnia were randomized to 1 of 3 conditions: classroom cognitive-behavioral treatment (CBT), home-based audio relaxation treatment (HART), or delayed-treatment control. Compared to the control group, the CBT group had significant changes in 5 of 7 self-report measures of sleep at the 4-month follow-up. The HART group obtained significant outcomes on 3 of 7 measures. Wrist actigraphy measures and secondary-outcome measures did not yield significant findings for either treatment. Clinically significant changes at follow-up were obtained for 54% of patients in CBT, 35% in HART, and 6% in the control group when treatment dropouts were included. Although not as effective as in-person CBT, home interventions may have utility as a first-line, low-cost treatment.
authors.affiliation: Department of Psychology, Rush-Presbyterian-St Luke's Medical Center, Rush University, Chicago, Illinois 60612-3833, USA. brybarcz@rush.edu
authors.forename: Bruce
authors.initials: B
authors.lastname: Rybarczyk
authors.forename: Martita
authors.initials: M
authors.lastname: Lopez
authors.forename: Rodney
authors.initials: R
authors.lastname: Benson
authors.forename: Christopher
authors.initials: C
authors.lastname: Alsten
authors.forename: Edward
authors.initials: E
authors.lastname: Stepanski
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012064:Relaxation Therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology* / Q000628:therapy*