Psychological treatment of insomnia in hypnotic-dependant older adults

Soeffing, James P.; Lichstein, Kenneth L.; Nau, Sidney D.; McCrae, Christina S.; Wilson, Nancy M.; Aguillard, R. Neal; Lester, Kristin W.; Bush, Andrew J.

doi:10.1016/j.sleep.2007.02.009

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Volume 9, Issue 2 , Pages 165-171, January 2008

Psychological treatment of insomnia in hypnotic-dependant older adults

James P. Soeffing
- Department of Psychology, The University of Alabama, USA
- Corresponding author. Tel.: +1 901 481 1480; fax: +1 205 348 5784.
Kenneth L. Lichstein
- Department of Psychology, The University of Alabama, USA
Sidney D. Nau
- Department of Psychology, The University of Alabama, USA
- Department of Psychology, University of Memphis, USA
Christina S. McCrae
- Department of Clinical & Health Psychology, University of Florida, USA
Nancy M. Wilson
- Department of Psychology, University of Memphis, USA
R. Neal Aguillard
- Sleep Disorders Center, Methodist Healthcare, USA
Kristin W. Lester
- Sleep Disorders Center, Methodist Healthcare, USA
Andrew J. Bush
- Department of Preventive Medicine, College of Medicine, UTHSC, Memphis, TN, USA

Received 30 November 2006; received in revised form 18 February 2007; accepted 25 February 2007.

Abstract

Background

The existing literature does not address the question of whether cognitive-behavioral therapy would have an impact on insomnia in older adults who are chronic users of sleep medication and have current insomnia, but are also stable in their quantity of medication usage during treatment. The present report seeks to answer this question.

Methods

Hypnotic-dependant older adults, who were stable in their amount of medication usage and still met the criteria for chronic insomnia put forth by American Academy of Sleep Medicine, were treated using a cognitive-behavioral intervention for insomnia. The three-component treatment included relaxation training, stimulus control, and sleep hygiene instructions. Participants were randomly assigned to either the active treatment group or a comparably credible placebo control group, and were instructed not to alter their pattern of hypnotic consumption during treatment.

Results

The active treatment group had significantly better self-report measures of sleep at post-treatment. Statistically significant improvement was paralleled by clinically meaningful improvement for key sleep variables. As planned, there was no significant change in sleep medication usage from pre- to post-treatment.