Psychological treatment of insomnia in hypnotic-dependant older adults.
BACKGROUND
The existing literature does not address the question of whether cognitive-behavioral therapy would have an impact on insomnia in older adults who are chronic users of sleep medication and have current insomnia, but are also stable in their quantity of medication usage during treatment. The present report seeks to answer this question.


METHODS
Hypnotic-dependant older adults, who were stable in their amount of medication usage and still met the criteria for chronic insomnia put forth by American Academy of Sleep Medicine, were treated using a cognitive-behavioral intervention for insomnia. The three-component treatment included relaxation training, stimulus control, and sleep hygiene instructions. Participants were randomly assigned to either the active treatment group or a comparably credible placebo control group, and were instructed not to alter their pattern of hypnotic consumption during treatment.


RESULTS
The active treatment group had significantly better self-report measures of sleep at post-treatment. Statistically significant improvement was paralleled by clinically meaningful improvement for key sleep variables. As planned, there was no significant change in sleep medication usage from pre- to post-treatment.


CONCLUSIONS
The findings support the use of cognitive-behavioral therapy for insomnia in hypnotic-dependant older adults.
Soeffing
James P
JP
Department of Psychology, The University of Alabama, USA. soeff001@bama.ua.edu
Lichstein
Kenneth L
KL
Nau
Sidney D
SD
McCrae
Christina S
CS
Wilson
Nancy M
NM
Aguillard
R Neal
RN
Lester
Kristin W
KW
Bush
Andrew J
AJ
D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D006993:Hypnotics and Sedatives