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    Psychological treatment for insomnia in the management of long-term hypnotic drug use: A pragmatic randomised controlled trial

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    Author
    Tomeny, Maureen
    Keyword
    Cognitive behavioural therapy
    Sleep wake disorders
    Date
    2003
    
    Metadata
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    DOI
    -
    Publisher's URL
    http://bjgp.org/content/53/497/923
    Abstract
    Objective: To evaluate the clinical and cost impact of providing cognitive behaviour therapy (CBT) for insomnia (comprising sleep hygiene, stimulus control, relaxation and cognitive therapy components) to long-term hypnotic drug users in general practice. Design: A pragmatic randomised controlled trial with two treatment arms (a CBT treated 'sleep clinic' group, and a 'no additional treatment' control group), with post-treatment assessments commencing at 3 and 6 months. Setting. Twenty-three general practices in Sheffield, UK Participants. Two hundred and nine serially referred patients aged 31-92years with chronic sleep problems who had been using hypnotic drugs for at least I month (mean duration 13.4 years). Results. At 3- and 6-month follow-ups patients treated with CBT reported significant reductions in sleep latency, significant improvements in sleep efficiency, and significant reductions in the frequency of hypnotic drug use (all P<0.01). Among CBT treated patients SF-36 scores showed significant improvements in vitality at 3 months (P<0.01). older age presented no barrier to successful treatment outcomes. The total cost of service provision was pound154.40 per patient, with a mean incremental cost per quality-adjusted life-year of pound3416 (at 6 months). However there was evidence of longer term cost offsets owing to reductions in sleeping tablet use and reduced utilisation of primary care services. Conclusions: In routine general practice settings, psychological treatments for insomnia can improve sleep quality and reduce hypnotic consumption at a favourable cost among long-term hypnotic users with chronic sleep difficulties.
    Citation
    Morgan, K., Dixon, S., Mathers, N., Thompson, J. & Tomeny, M. (2003). Psychological treatment for insomnia in the management of long-term hypnotic drug use: A pragmatic randomised controlled trial. British Journal of General Practice, 53 (497), pp.923-928.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/6113
    Collections
    Neurological Conditions
    Drug Misuse

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