title: A double-blind randomised controlled study of a brief intervention of bedtime restriction for adult patients with primary insomnia.
abstract: BACKGROUND
  Bedtime restriction is effective for volunteer patients with primary insomnia.
  
  
  OBJECTIVE
  To determine the effectiveness of bedtime restriction in adult volunteers with primary insomnia.
  
  
  METHODS
  Patients were recruited in response to articles in local newspapers. The study hypothesis was not given in the articles. Patients were assessed as to whether or not they had primary insomnia. They completed a two-week sleep diary after which they met the investigators and were randomised to either bedtime restriction and basic sleep hygiene or the control group with basic sleep hygiene only. A total of 224 potential participants applied to be in the study. Of the 52 who had primary insomnia, 45 were randomly allocated to either control or intervention group and only two did not complete the study. Randomisation was concealed and participants were blinded regarding the treatment. The primary outcome was also measured in a blinded fashion.
  
  
  RESULTS
  The outcome evaluated was patient description of 'better' or 'much better' quality of sleep versus the 'same', 'worse' or 'much worse' quality of sleep at six weeks. Overall, 73% (16/22) of those in the intervention group were either having better or much better quality of sleep after treatment, while in the control group this was 35% (8/23). The number needed to treat was 3 [95% CI 2-11] for bedtime restriction and sleep hygiene versus sleep hygiene alone.
  
  
  CONCLUSIONS
  This is the first study using bedtime restriction designed to be feasible in primary care by using a brief intervention and a patient-oriented outcome.
authors: Faculty of Medical and Health Sciences, The University of Auckland, PB 92019, Auckland, New Zealand. a.fernando@auckland.ac.nz
authors: Antonio
authors: A
authors: Fernando
authors: Bruce
authors: B
authors: Arroll
authors: Karen
authors: K
authors: Falloon
mesh_terms: D000328:Adult; D000368:Aged; D001513:Beds; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010865:Pilot Projects; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors