Cognitive Behavioral Therapy vs Zopiclone for Treatment of Chronic Primary Insomnia in Older Adults

Sivertsen, Børge; Omvik, Siri; Pallesen, Ståle; Bjorvatn, Bjørn; Havik, Odd E.; Kvale, Gerd; Nielsen, Geir Høstmark; Nordhus, Inger Hilde

doi:10.1001/jama.295.24.2851

Cited by 524 publications

(325 citation statements)

References 42 publications

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“…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).…”

Section: Resultsmentioning

confidence: 98%

“…In the same study, the CBT group exhibited an increase in sleep stages 3 and 4 and a decrease in time awake during the PSG as compared to the zopiclone or placebo groups. 25 In another study, cognitive changes were correlated with improvements noted on both objective (PSG) and subjective measures of insomnia symptoms, particularly within the CBT group. 31 …”

Section: Polysomnography (Psg)mentioning

confidence: 94%

“…In one study of maintenance insomnia, 25.8% of subjects demonstrated clinically significant improvements at the six-month follow-up in both interventions (sleep hygiene + stimulus control vs. sleep hygiene + relaxation tape). Changes from pretreatment to followup were generally significant, showing that the treatment gains were stable and long-lasting.…”

Section: Follow-upmentioning

confidence: 99%

“…13 Both studies on this topic showed that these interventions can ameliorate sleep quality 24 and reduce the use of hypnotic drugs. [24][25][26][27] These results offer an important example of how mind-body interventions can help allopathic medicine.…”

Section: General Commentsmentioning

confidence: 99%

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

Kozasa

Hachul

Monson

et al. 2010

Rev. Bras. Psiquiatr.

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Objective: As insomnia is highly prevalent, and side effects of medication are well-known, mind-body interventions are increasingly being sought. The objective of this study is to present a narrative review regarding the effects of mind-body interventions for the treatment of insomnia. Method: A PubMed search was conducted including only randomized, controlled trials in which the main objective was to treat insomnia. Discussion: Twelve studies were selected. In three of the studies, objective parameters (polysomnography) were analyzed. Mind-body interventions were able to improve sleep efficiency and total sleep time. Most can ameliorate sleep quality; some can reduce the use of hypnotic drugs in those who are dependent on these drugs. Conclusion: According to the studies we selected, self-reported sleep was improved by all mind-body treatments, among them yoga, relaxation, Tai Chi Chih and music. Cognitive behavioral therapy seems to be the most effective mind-body intervention. Cognitive behavioral therapy was the only intervention that showed better results than medication. However, considering that only five of the twelve studies chosen reached a score of 3 in the Jadad scale, new studies with a higher methodological quality have to be conducted especially in mind-body interventions that belong to the complementary or alternative medicine field.

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Section: Resultsmentioning

confidence: 98%

Section: Polysomnography (Psg)mentioning

confidence: 94%

Section: Follow-upmentioning

confidence: 99%

Section: General Commentsmentioning

confidence: 99%

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

Kozasa

Hachul

Monson

et al. 2010

Rev. Bras. Psiquiatr.

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“…CBTI is considered first-line treatment for chronic insomnia and can be successfully utilized in patients with mTBI [100][101][102][103][104][105]. Previous reports have shown that CBTI reduced daytime fatigue and improved nocturnal sleep quality among patients with TBI [48].…”

Section: Insomnia and Circadian Dysregulationmentioning

confidence: 99%

Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group

et al. 2016

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Disturbed sleep is one of the most common complaints following traumatic brain injury (TBI) and worsens morbidity and long-term sequelae. Further, sleep and TBI share neurophysiologic underpinnings with direct relevance to recovery from TBI. As such, disturbed sleep and clinical sleep disorders represent modifiable treatment targets to improve outcomes in TBI. This paper presents key findings from a national working group on sleep and TBI, with a specific focus on the testing and development of sleep-related therapeutic interventions for mild TBI (mTBI). First, mTBI and sleep physiology are briefly reviewed. Next, essential empirical and clinical questions and knowledge gaps are addressed. Finally, actionable recommendations are offered to guide active and efficient collaboration between academic, industry, and governmental stakeholders.

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Efficacy of an Internet-Based Behavioral Intervention for Adults With Insomnia

Ritterband

Thorndike²,

Gönder-Frederick³

et al. 2009

Arch Gen Psychiatry

433

294

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Context: Insomnia is a major health problem with significant psychological, health, and economic consequences. However, availability to one of the most effective insomnia treatments, Cognitive Behavioral Therapy (CBT), is significantly limited. The Internet may be a key conduit for delivering this intervention. Objective: To evaluate the efficacy of a structured behavioral Internet intervention for adults with insomnia. Design, Setting, and Participants: 45 adults were randomly assigned to an Internet intervention (n=22) or wait-list control group (n=23). 44 eligible participants were included in the analyses (mean age, 44.86±11.03 years; 34 women), who had, on average, a history of sleep difficulties greater than 10 years (10.59±8.89). Intervention: The Internet intervention is based on well-established face-to-face CBT, incorporating the primary components of sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, and relapse prevention. Main Outcome Measure(s): The Insomnia Severity Index (ISI) and daily sleep diary data were used to determine changes in insomnia severity and the main sleep variables, including wake after sleep onset (WASO) and sleep efficiency (SE). Results: Intent-to-treat analyses showed that scores on the ISI significantly improved from 15.73 (95% CI, 14.07-17.39) to 6.59 (95% CI, 4.73-8.45) for the Internet group, but did not change for the control group, 16.27 (95% CI, 14.61-17.94) to 15.50 (95% CI, 13.64-17.36), F (1, 42) = 29.64, p<.001. The Internet group maintained their gains at six month follow-up. Internet participants also achieved significant decreases in WASO (55%; 95% CI, 34%-76%) and increases in SE (16%; 95% CI, 9%-22%) compared to the non-significant control group changes of WASO (8%; 95% CI, −17%-33%) and SE (3%; 95% CI, −4%-9%). Conclusions: Participants who received the Internet intervention for insomnia significantly improved their sleep, whereas the control group did not change. The Internet appears to have considerable potential in delivering a structured behavioral program for insomnia.

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Cognitive Behavioral Therapy vs Zopiclone for Treatment of Chronic Primary Insomnia in Older Adults

Abstract: clinicaltrials.gov Identifier: NCT00295386.

Cited by 524 publications

References 42 publications

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

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

Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group

Efficacy of an Internet-Based Behavioral Intervention for Adults With Insomnia

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