title: Cognitive behavioural therapy with behavioural analysis for pharmacological treatment-resistant chronic insomnia.
abstract: This study aimed to determine whether (1) cognitive behavioural therapy with behavioural analysis for insomnia (CBTi-BA) is more effective for insomnia and co-morbid depressive symptoms than treatment as usual (TAU) and (2) whether CBTi-BA promotes earlier reduction of the daily dose of hypnotic medication in chronic insomnia resistant to pharmacological treatment. A total of 63 patients with chronic insomnia aged 20-77 years who already received hypnotic medication regularly were assigned to two interventions: combined therapy or TAU alone. The subjects provided demographic information and completed self-rating scales for insomnia and depressive symptoms. After treatment, the combined therapy group showed significant decreases in the symptoms of both insomnia and depression and significant reductions in the daily dose of hypnotic medication compared with the group receiving TAU alone. In the combined therapy group, 71% of the participants reported a reduction in insomnia to normal levels and 79% succeeded in decreasing the daily dose of hypnotics to 50% or less of the baseline dose. These results revealed that CBTi-BA can reduce insomnia and depressive symptoms as well as the daily dose of hypnotic medication in patients with chronic insomnia resistant to pharmacological treatment.
authors: Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan; Yoyogi Sleep Disorder Center, Tokyo, Japan. Electronic address: okajima@somnology.com.
authors: Isa
authors: I
authors: Okajima
authors: Masaki
authors: M
authors: Nakamura
authors: Shingo
authors: S
authors: Nishida
authors: Akira
authors: A
authors: Usui
authors: Ken-Ichi
authors: K
authors: Hayashida
authors: Meri
authors: M
authors: Kanno
authors: Shun
authors: S
authors: Nakajima
authors: Yuichi
authors: Y
authors: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives
keywords: Behavioural analysis; Cognitive behavioural therapy; Hypnotics; Insomnia; Treatment-resistant