title: Sequential combinations of drug and cognitive behavioral therapy for chronic insomnia: an exploratory study.
abstract: This study explores the efficacy of sequential treatments involving medication and cognitive behavioral treatment (CBT) for primary insomnia. Seventeen participants took part in a multiple baseline design and were assigned to: (a) medication for 5 weeks, followed by combined medication plus CBT for 5 weeks; (b) combined treatment for 5 weeks, followed by CBT alone; or (c) CBT alone. Each treatment sequence produced significant sleep improvements, but at different points in time. For the first sequence, most of the sleep improvement was obtained after the introduction of CBT, while for the other sequence and CBT alone, improvement appeared during the first weeks. These results suggest that sleep improvement seems affected by the way treatments are combined. Also, a sequence beginning with a combined treatment followed by CBT alone seems to produce the best outcome. Additional research should be conducted with larger samples to determine the most effective sequence.
authors.affiliation: Ecole de psychologie, Université Laval, Pavillon FAS, Québec, Canada G1K 7P4. annie.vallieres@psy.ulaval.ca
authors.forename: Annie
authors.initials: A
authors.lastname: Vallières
authors.forename: Charles M
authors.initials: CM
authors.lastname: Morin
authors.forename: Bernard
authors.initials: B
authors.lastname: Guay
mesh_terms: D000328:Adult; D053961:Azabicyclo Compounds; D001521:Behavior Therapy / Q000379:methods; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D017286:Polysomnography; D011594:Psychometrics; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone