Psychological treatment for insomnia in the regulation of long-term hypnotic drug use

Morgan K, Dixon S, Mathers N, Thompson J, Tomeny M
Record ID 32004000150
English
Authors' objectives:

This study was designed: (1) to evaluate the clinical and cost impact of providing, in routine general practice settings, a cognitive-behaviour therapy (CBT) package for insomnia (comprising information, sleep hygiene, stimulus control, relaxation and cognitive therapy components) to long-term (>=1 month) hypnotic drug users with chronic sleep difficulties; and (2) to identify factors associated with variations in clinical outcomes.

Authors' recommendations: Despite chronic hypnotic drug use ostensibly to manage persistent insomnia, patients in the trial reported very high levels of sleep disturbance and very low levels of sleep quality. In routine general practice settings, psychological treatment for insomnia can improve sleep quality, reduce hypnotic drug use, and improve health-related quality of life at a favourable cost among long-term hypnotic users with chronic sleep difficulties. These positive outcomes appear robust over time, persisting for at least 1 year among the more treatment-adherent patients. While these benefits may be reduced among those patients presenting with higher levels of psychological distress, the present study clearly indicates that older age per se presents no barrier to successful treatment outcomes. CBT for insomnia should be considered by primary care commissioners and practitioners when implementing National Service Framework recommendations for benzodiazepine use, and when addressing the insomnia management needs of patients with longer term sleep difficulties.
Authors' methods: Randomised controlled trial
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1050
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Hypnotics and Sedatives
  • Psychotherapy
  • Sleep Initiation and Maintenance Disorders
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.