Psychological Treatment of Insomnia in Hypnotic-dependant Older Adults

Show simple item record Lichstein, Kenneth Nau, Sidney D. Wilson, Nancy M. Aguillard, R. Neal Lester, Kristin W. Bush, Andrew J. McCrae, Christina S. 2021-05-14T13:23:20Z 2021-05-14T13:23:20Z 2008-01
dc.identifier.citation Soeffing, J., Lichstein, K., Nau, S., McCrae, C., Wilson, N., Aguillard, R., Lester, K., Bush, A. (2008): Psychological Treatment of Insomnia in Hypnotic-dependant Older Adults Sleep Medicine, 9(2). en_US
dc.description.abstract Objective: This study tested cognitive behavior therapy (CBT) in hypnotic-dependent, late middle-age and older adults with insomnia. Method: Seventy volunteers age 50 and older were randomized to CBT plus drug withdrawal, placebo biofeedback (PL) plus drug withdrawal, or drug withdrawal (MED) only. The CBT and PL groups received eight, 45 minute weekly treatment sessions. The drug withdrawal protocol comprised slow tapering monitored with about six biweekly, 30 minute sessions. Assessment including polysomnography (PSG), sleep diaries, hypnotic consumption, daytime functioning questionnaires, and drug screens collected at baseline, posttreatment, and 1-year follow-up. Results: Only the CBT group showed significant sleep diary improvement, sleep onset latency significantly decreased at posttreatment. For all sleep diary measures for all groups, including MED, sleep trended to improvement from baseline to follow-up. Most PSG sleep variables did not significantly change. There were no significant between group differences in medication reduction. Compared to baseline, the three groups decreased hypnotic use at posttreatment, down 84%, and follow-up, down 66%. There was no evidence of withdrawal side-effects. Daytime functioning, including anxiety and depression, improved by posttreatment. Rigorous methodological features, including documentation of strong treatment implementation and the presence of a credible placebo, elevated the confidence due these findings. Conclusions: Gradual drug withdrawal was associated with substantial hypnotic reduction at posttreatment and follow-up, and withdrawal side-effects were absent. When supplemented with CBT, participants accrued incremental self-reported, but not PSG, sleep benefits. en_US
dc.format.mimetype application/pdf
dc.language English en_US
dc.subject hypnotic dependence en_US
dc.subject drug withdrawal en_US
dc.subject insomnia en_US
dc.subject cognitive behavior therapy en_US
dc.title Psychological Treatment of Insomnia in Hypnotic-dependant Older Adults en_US
dc.type text

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