Results of randomized controlled trials of the effect of cognitive behavioural therapy on sleep quality
| Study | Duration of treatment | Participants | Mean age, yr | Study group | Outcomes | |
|---|---|---|---|---|---|---|
| Intervention | Comparator | |||||
| Morgan et al.31 | 6 wk of active treatment; follow-up at 3 and 6 mo | 209 people using benzodiazepines for > 1 mo; mean duration of use 13.4 yr | 68 | Six 50-min sessions of cognitive behavioural therapy | Usual care with crossover to cognitive behavioural therapy | At 3 mo, intervention group had significant improvement in Pittsburgh scores (mean difference −3.8, 95% CI −4.8 to −2.8), decrease in sleep latency (mean difference −24.1, 95% CI −37.2 to −11.1), improvement in sleep efficiency (mean difference −0.9, 95% CI 1.2 to −0.6) and increase in total sleep time (mean difference 0.5 min, 95% CI 0.1 to 0.8); 47.4% v. 17.3% reported low-frequency use (p < 0.001); 30% v. 11% reported zero hypnotic drug use over 7-d follow-up assessment period (p = 0.005) At 6 mo, intervention group had significant decrease in sleep latency (mean difference −27.9 min (95% CI −43.4 to −12.6) and improvement in sleep efficiency score (mean difference −1 (95% CI −1.3 to −0.6); 54% v. 18% reported low-frequency use (p < 0.001); 33% v. 8% reported zero hypnotic drug use (p < 0.001) |
| Morin et al.32 | 10 wk | 76 chronic benzodiazepine users (> 50% of nights for > 3 mo); mean 6.7 nights per wk; mean duration of use 19.3 yr | 62.5 | Combined benzodiazepine tapering and cognitive behavioural therapy | Benzodiazepine tapering alone or cognitive behavioural therapy alone | Overall, 90% reduction in quantity of benzodiazepine consumption and 80% reduction in frequency of medicated nights across the 3 groups; 63% of patients were benzodiazepine free within 7 wk on average; 85% in combined treatment arm were benzodiazepine free after initial intervention v. 48% in tapering arm and 54% in cognitive behavioural therapy arm |
| Baillargeon et al.33 | 8 wk | 65 daily benzodiazepine users for > 3 mo; mean duration of use 152 mo (12.7 yr) | 67.4 | Combined benzodiazepine tapering and cognitive behavioural therapy (90-min group session weekly for 8 wk) | Benzodiazepine tapering alone | 77% in combined treatment arm v. 38% in tapering arm were benzodiazepine free immediately after treatment (OR 5.3, 95% CI 1.8 to 16.2); this outcome persisted at 12 mo, with 70% benzodiazepine free in combined treatment arm v. 24% in tapering only arm (OR 7.2, 95% CI 2.4 to 23.7) |
| Voshaar et al.34 | 3 mo | 180 regular benzodiazepine users for > 3 mo; mean duration of use 165 mo (13.8 yr) | 63.4 | Benzodiazepine tapering alone or combined with cognitive behavioural therapy (2-h session weekly for 5 wk) | Usual care | 62% in tapering arm and 58% in combined treatment arm were successful with discontinuation v. 21% in usual care arm |
Note: CI = confidence interval, OR = odds ratio.