Placebo effects in primary insomnia.
Placebo effects are commonly observed in insomnia clinical trials. With the advent of longer-term trials, such effects appear to be remarkably robust and durable. In this paper we review the classic factors that are believed to contribute to placebo effects and how these factors operate in insomnia randomized clinical trials. Beyond this we suggest that the episodic nature of insomnia may interact with patient preferences for intermittent dosing in such a way as to sustain placebo effects in the long term. An appreciation of the latter phenomenon may provide increased power to detect therapeutic outcomes and may be used to potentiate clinical gains.
Perlis
Michael L
ML
Sleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester, 300 Crittenden Blvd. Rochester, NY 14642, USA. michael_perlis@urmc.rochester.edu
McCall
W Vaughn
WV
Jungquist
Carla R
CR
Pigeon
Wilfred R
WR
Matteson
Sara E
SE
D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D010507:Periodicity; D015990:Placebo Effect; D016032:Randomized Controlled Trials as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*
D006993:Hypnotics and Sedatives