This paper is only available as a PDF. To read, Please Download here.
Purpose
This clinical replication series assessed the perceived outcome of individuals with
chronic insomnia who spontaneously sought treatment at a hospital behavioral-medicine
insomnia program. patients and methods: Chronic insomnia patients who were treated with a group multifactor behavioral intervention
completed posttreatment (n = 102) and 6-month follow-up (n = 70) questionnaires that
assessed improvement.
Results
All patients reported improved sleep at posttreatment, with the majority (58%, 59)
reporting significant improvement. Of sleep medication users, 91% (62/68) either eliminated
or reduced medication use. At 6-month follow-up, 90% (63/70) of respondents rated
improvement in sleep as either maintained or enhanced.
Conclusion
These results suggest that patients spontaneously seeking treatment for insomnia,
including sleep medication users and those with psychological comorbidity, derive
significant benefit from a group multifactor behavioral intervention. Several factors,
including maintenance of therapeutic gains at long-term follow-up, the average pretreatment
duration of insomnia, previous unsuccessful treatment with psychotherapy and pharmacotherapy,
and previous research, argue against nonspecific effects playing a significant role
in these results.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Executive Summary and Executive Report submitted to the United States Congress and to the Secretary, Department of Health and Human Services. A Report of the National Commission on Sleep Disorders Research. Wake Up America! A National Sleep Alert. Vol. 1. NCSDR, Washington, DC1993
- Biopsychobehavioral correlates of insomnia, V: clinical characteristics and behavioral correlates.Am J Psychiatry. 1984; 141: 1371-1376
- Sleep problems in the community elderly as predictors of death in nursing home placement.J Community Health. 1990; 15: 123-135
- Behavioral Treatment for Persistent Insomnia. Pergamon, New York1987
- Epidemiologic study of sleep disturbances and psychopathology. An opportunity for prevention?.JAMA. 1989; 262: 1479-1484
- Behavioral and pharmacological treatments for insomnia.Ann Behav Med. 1988; 10: 91-100
- Diagnosis and management of insomnia.NEJM. 1990; 322: 239-248
- The Steep Disorders.Upjohn, Kalamazoo, Michigan1982
- Benzodiazepine withdrawal: overview and implications for treatment of anxiety.Am J Med. 1988; 84: 1041-1052
- Effect of gradual withdrawal on the rebound sleep disorder after discontinuation of Triazolam.NEJM. 1987; 317: 722-728
- Drugs and insomnia: the use of medications to promote sleep.JAMA. 1984; 251: 2410-2414
- Recent advance in the assessment and treatment of insomnia.J Consult Clin Psychol. 1992; 60: 586-594
- Insomnia.in: Hersen M Bellack A Handbook of Clinical Behavior Therapy With Adults. Plenum, New York1985
- Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy.Am J Psychiatry. 1994; 151: 1172-1180
- Home-based central nervous system assessment of a multifactor behavioral intervention for chronic sleep-onset insomnia.Behavior Therapy. 1993; 24: 159-174
- Characteristics of individuals who do or do not seek treatment for chronic insomnia.Psychosom. 1989; 30: 421-427
- International Classification of Sleep Disorders (ICSD): Diagnostic and Coding Manual. ASDA, Rochester, Minnesota1990
- Insomnia: Psychological Assessment and Management. Guilford, New York1993
- Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints.Psychol Aging. 1993; 8: 463-467
- The factorial structure of sleep dissatisfaction.Behav Res Ther. 1991; 29: 513-520
- SCL-90R Revised Version Manual. Leonard Derogatis, Baltimore, Maryland1977
- Substituting behavioural treatment for drugs in the treatment of insomnia: an exploratory study.J Behav Ther Exper Psychiatry. 1988; 19: 51-56
- The placebo effect—a neglected asset in the care of patients.JAMA. 1975; 232: 1225-1227
- A conditioned response model of the placebo effect: predictions from the model.in: White L Tursky B Schwartz G Placebo: Theory, Research and Mechanisms. Guilford, New York1985
- Patients' acceptance of psychological and pharmacological therapies for insomnia.Sleep. 1992; 15: 302-305
- Improving your sleep.in: Benson H Stuart E The Wellness Book. Simon & Schuster, New York1992
Article Info
Publication History
Accepted:
June 23,
1995
Received:
December 13,
1994
Identification
Copyright
© 1996 Published by Elsevier Inc.
