title: Sleep restriction therapy and hypnotic withdrawal versus sleep hygiene education in hypnotic using patients with insomnia.
abstract: OBJECTIVE
  Insomnia is a common problem that affects 9% to 15% of the population chronically. The primary objective of this study was to demonstrate that 8 weekly sessions of sleep restriction therapy of insomnia combined with hypnotic reduction instructions following a single session of sleep hygiene education would result in greater improvements in sleep and hypnotic use than sleep hygiene education alone.
  
  
  METHODS
  Forty-six men and women were recruited from a sleep medicine practice and randomly assigned to sleep hygiene education plus 8 weeks of sleep restriction and hypnotic withdrawal (SR+HW; n = 24), or a sleep hygiene education alone (SHE; n = 22) condition. Pre-randomization, all patients received a single session of instruction in good sleep habits (sleep hygiene education).
  
  
  RESULTS
  The SR+HW condition had greater improvements in hypnotic medication usage, sleep onset latency, morning wake time, sleep efficiency, and wake time after sleep onset (trend), than the SHE condition. Continued improvement was seen in TST in the SR+HW group at 6-month follow-up, and gains on all other variables were maintained at 6- and 12-month follow-up.
  
  
  CONCLUSIONS
  These results provide evidence that more intensive treatment of insomnia (i.e., 8 sessions of SR+HW plus hypnotic withdrawal instructions) results in better outcomes than SHE alone.
authors.affiliation: University of North Texas, Denton, TX 762031280, USA. djtaylor@unt.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Taylor
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schmidt-Nowara
authors.forename: Carol A
authors.initials: CA
authors.lastname: Jessop
authors.forename: John
authors.initials: J
authors.lastname: Ahearn
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D017286:Polysomnography / Q000379:methods; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D014851:Wakefulness
chemical_list: D006993:Hypnotics and Sedatives
references.citation: Sleep Med Rev. 2002 Apr;6(2):97-111
references.pmid: 12531146
references.citation: Sleep. 2003 Mar 15;26(2):177-82
references.pmid: 12683477
references.citation: J Geriatr Psychiatry Neurol. 2000 Spring;13(1):17-27
references.pmid: 10753003
references.citation: Br J Gen Pract. 2003 Dec;53(497):923-8
references.pmid: 14960215
references.citation: Behav Modif. 1999 Jul;23(3):379-402
references.pmid: 10467890
references.citation: Sleep. 1999 May 1;22 Suppl 2:S386-93
references.pmid: 10394612
references.citation: Behav Res Ther. 2001 Jan;39(1):45-60
references.pmid: 11125723
references.citation: Sleep. 1987 Feb;10(1):45-56
references.pmid: 3563247
references.citation: Sleep. 2006 Nov;29(11):1398-414
references.pmid: 17162986
references.citation: Am J Psychiatry. 2002 Jan;159(1):5-11
references.pmid: 11772681
references.citation: J Gerontol. 1991 Jan;46(1):P1-8
references.pmid: 1986039
references.citation: Sleep. 2006 Nov;29(11):1415-9
references.pmid: 17162987
references.citation: Behav Modif. 1998 Jan;22(1):3-28
references.pmid: 9567734
references.citation: Sleep Med. 2008 Jan;9(2):165-71
references.pmid: 17644419
references.citation: Arch Intern Med. 2004 Sep 27;164(17):1888-96
references.pmid: 15451764
references.citation: Am J Psychiatry. 2004 Feb;161(2):332-42
references.pmid: 14754783
references.citation: Sleep. 2007 May;30(5):574-84
references.pmid: 17552372
references.citation: JAMA. 2006 Jun 28;295(24):2851-8
references.pmid: 16804151
references.citation: JAMA. 1999 Mar 17;281(11):991-9
references.pmid: 10086433
references.citation: Eur Arch Psychiatry Clin Neurosci. 1993;242(6):329-36
references.pmid: 8323982
references.citation: Psychol Med. 2003 Oct;33(7):1223-37
references.pmid: 14580077
references.citation: Proc (Bayl Univ Med Cent). 2008 Jul;21(3):264-5
references.pmid: 18628925