Behavioral and Hypnotic Treatments for Insomnia Subtypes

Abstract

This investigation compared progressive muscle relaxation plus cognitive distraction (PMR/CD), hypothesized to better improve sleep onset, versus sleep restriction and stimulus control (SR/SC), hypothesized to better improve sleep maintenance, versus a flurazepam (Dalmane) positive contrast condition (MED) and a sleep hygiene education minimal treatment control condition (SHE). Participants with chronic insomnia (N = 53), completed 2 baseline weeks of sleep diaries, and were randomly assigned to a treatment group for 2 more weeks. In the second phase, PMR/CD participants were assigned to 2 weeks of PMR/CD + SR/SC + SHE while SHE participants continued SHE. Results indicated that PMR/CD had greater effect upon sleep onset than SR/SC and SHE, SR/SC had greater effect on sleep maintenance than PMR/CD, and MED was better than the other treatments. In the second phase, the treatment package produced modest additional improvements and SHE performed superior to expectations.

Self‐relaxation training can improve sleep quality and cognitive functions in the older: a one‐year randomised controlled trial

“…In a systematic review, Taylor and Roane (2010) pointed out that PMR, among several recommended psychological treatments for the management of sleep disturbance, had the best research support. Waters et al (2003) found that PMR had greater effect upon sleep onset than other non-pharmacologic approaches, like sleep restriction or stimulus control. PMR can relax the muscles of the whole body and decrease the nervous tension, improving the sleep quality.…”

“…Waters et al . () found that PMR had greater effect upon sleep onset than other non‐pharmacologic approaches, like sleep restriction or stimulus control. PMR can relax the muscles of the whole body and decrease the nervous tension, improving the sleep quality.…”

Mind-body interventions for the treatment of insomnia: a review

“…In one of these studies, CBT showed better results than zopiclone; 25 in the other study, flurazepam was superior to progressive muscle relaxation plus cognitive distraction (PMR/ CD), sleep restriction and stimulus control (SR/SC) or sleep hygiene education. 28 Most of the studies compared mind-body intervention with no treatment (waiting-list control). However, two studies showed that mind-body interventions can improve sleep quality of long-term hypnotic drug users.…”

“…It is presented along with other interventions 21,24,25,30 like CBT or an active control. 28 Considering that many insomniacs present "bad" habits before sleep, these instructions per se can change the quality of sleep.…”

Characterization of Patients Who Present With Insomnia: Is There Room for a Symptom Cluster-Based Approach?

“…47,49 Nightly insomnia symptoms (sleep onset or sleep maintenance problems or EMA) have also been associated with different disease characteristics [50][51][52][53][54][55][56] and treatment responses. 57,58 More recently, the heterogeneity driven by objective TST has garnered attention. A number of studies have highlighted differential outcomes associated with short versus long objective sleep.…”